CH 40 Benign Disorders of the Uterine Cervix

Question 1

Nabothian cysts

Answer 1

develop when cleft or tunnel of columnar endocervical epithelium becomes covered by squamous metaplasia. They appear grossly as translucent or yellow and may vary in diameter

Question 2

cervical polyps

Answer 2

Small pedunculated sessile neoplasms of the cervix. originate in endocervix or portio. Made of vacular connective tissue stroma and covered by columnar squamocolumnar or squamous epithelium

Question 3

cervical polyps signs and symptoms

Answer 3

intermenstrual or postcoital bleeding, leukorrhea, menorrhagia, abnormal vaginal bleeding, postmenopausal bleeding, may cause infertility

Question 4

what do cervical polyps look like

Answer 4

smooth, red, fingerlike projections from cervical canal. To soft to be felt by fingers

Question 5

cervical polyps xray findings

Answer 5

those high in endocervical canal can be seen using hysterosalpingogram or saline infusion sonohysterography.

Question 6

cervical polyps lab findings

Answer 6

vaginal cytology will reveal signs of infection and mildly atypical cells. Blood and urine studies not helpful

Question 7

cervical polyps complications

Answer 7

some may be infected with viral staphylcocci, streptococci, or other pathogens. give broad spectrum antibiotic at first sign of infection. Acute salpingitis can be initiated or exacerbated by polypectomy

Question 8

cervical polyps treatment

Answer 8

treat infection, remove polyps in office. Grasp with forceps and twist until it is avulsed (will cause a little bleeding), cauterize the base to reduce the bleeding. large polyps may need to be removed in OR with hysteroscope. Send tissue to pathologist

Question 9

papillomas of the cervix

Answer 9

benign neoplasms found in ectocervix. 2 types: one solitary papillary projection from exocervix composed of central core of fibrous connective tissue covered by stratified squamous epithelium OR condylomata of cervix varying from slightly raised area to typical condyloma acuminatum

Question 10

papillomas of the cervix signs and symptoms

Answer 10

no characteristic symptoms, usually just seen during routine pelvic exam or colposcopy

Question 11

papillomas of the cervix labs

Answer 11

cytologic findings of koilocytes (squamous cells with perinuclear clear halos) strongly suggestive of HPV. dysplastic squamous cells are frequently found. Biopsy of epithelium reveals papillomatosis and acanthosis.

Question 12

papillomas of the cervix complications

Answer 12

intraepithelial neoplasia associated with certain HPV infections, increasing risk of GU carcinoma

Question 13

papillomas of the cervix treatment

Answer 13

solitary papillomas should be surgically excised and submitted for pathologic exam. Colposcopy directed biopsy of flat condylomata should be submitted for histopathologic exam. Remove small condylomata may be completely removed with biopsy, large ones can be removed with cryotherapy, loop excision, or laser vaporization. Manage dysplasia

Question 14

leiomyomas of the cervix

Answer 14

most often solitary and large enough to fill entire pelvic cavity, compressing bladder, rectum, and ureters

Question 15

leiomyomas of the cervix signs and symptoms

Answer 15

silent, producing no symptoms unless they become very large and cause pressure on surrounding organs., frequency, urgency, hematometra, ureteral obstruction with hydronephrosis, rectal encroachment, constipation, dyspareunia, during pregnancy may prevent descent of presenting part in pelvis

Question 16

leiomyomas of the cervix imaging

Answer 16

xray may show mottled calcific pattern associated with cervical leiomyoma. hysterography may define distortion of endocervical canal. IV urography may show ureteral displacement. Transvaginal US and MRI can show size and location

Question 17

leiomyomas of the cervix treatment

Answer 17

small ones don’t need treatment. Symptomatic ones should be removed via hysteroscopic resection, uterine artery embolization, abdominal myomectomy, or hysterectomy. Ureter at risk for damage, may need to place stent to reduce risk