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Pathology 2 Block 2 > Disorders of the Uterus > Flashcards

Disorders of the Uterus Flashcards

1
Q

what are the Disorders of Uterus and endometrium?

A
  • Adenomyosis*
  • Endometriosis*
  • Endometrial hyperplasia*
  • Endometrial carcinoma*
  • Leiomyoma*
  • Leiomyosarcoma*
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2
Q

what is adenomyosis?

what are the clinical findings here?

A

presence of endometrial glands and stroma within the myometrium**.

  • Menorrhagia, dysmenorrhea and Pelvic pain
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3
Q

how do you diagnose adenomyosis?

A

myometrial biopsy

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4
Q

what is endometriosis?

what will patients note?

A
  • Presence of benign ,functional endometrial glands and stroma OUTSIDE** of the uterus
  • excess bleeding because cells outside of uterus will bleed as well in menses
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5
Q

what are the areas most involved in endometriosis?

where does it spread?

A

most common ovaries

rectal pouch, fallopian tubes, intestines

to ectopic sites (metaplasia of multipotential celomic peritoneum)

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6
Q

what are the gross findings in endometriosis?

A
  • red brown serosal nodules
  • fibrosis in ectopic sites
  • powder burns (surface of affected area is scarred and becomes gross brown discoloration)
    • ​scarring can cause intestinal obstruction
  • ovaries will have cysts due to repeated hemorrhages
    • look for chocolate cysts (cysts have chocolate looking material)
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7
Q

how do you diagnose endometriosis?

what are the clinical findings of endometriosis?

A

laproscopy

  1. Dysmenorrhea
    • implants are on uterosacral ligament
  2. Painful stooling during menses
    • implants on rectal pouch
  3. Intestinal obstruction and bleeding during menses
    • implants on serosal surface of intestine
  4. Enlargement of ovaries (chocolate cysts)
  5. Infertility and ectopic pregnancy
    • implants are on fallopian tube
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8
Q

what is endometrial hyperplasia?

what causes endometrial hyperplasia?

what are the risk factors for endometrial hyperplasia?

A

abnormal proliferation of endometrial glands.

excess and unopposed estrogenic stimulation.

  • taking estrogen with w/o progesterone
  • obesity
  • polycystic ovary syndrome (you have a lot of estrogen)
  • estrogen-producing tumor (granulosa cell tumor)
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9
Q

what are the 3 classifications of endometrial hyperplasia?

A
  1. simple
  2. complex
  3. atypical
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10
Q

what are the characteristics for simple endometrial hyperplasia?

A
  • Increased number of cystically dialted glands
  • No gladular crowding
  • No cytologic atypia
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11
Q

what are the characteristics for complex endometrial hyperplasia?

A
  • Increased number of dilated glands
  • Glandular crowding
  • No cytologic atypia
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12
Q

what are the characteristics for atypical endometrial hyperplasia?

what risk can atypical endometrial hyperplasia present?

A
  • Glandular crowding and dysplastic epithelium
  • Increased risk for endometrial cancer
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13
Q

what are clinical findings in endometrial hyperplasia?

there is a risk for endometrial hyperplasia to progress to what?

A
  • Abnormal uterine bleeding
  • Menorrhagia or irregular menses
  • Increased risk of progression to endometrial adenocarcinoma
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14
Q

there is Increased risk of progression to endometrial adenocarcinoma, but which type of endometrial hyperplasia has the most probable progression and which has the least?

A
  • Least with simple
  • Max with atypical.
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15
Q

endometrial hyperplasia affects most commonly what part of the population?

what is the most common clinical presentation?

what risk factor can increase the chance of endometrial carcinoma?

A

post-menopausal women

post-menopausal vaginal bleeding

prolonged estrogen stimulation

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16
Q

what are the different endometrial cancers?

which is the most common?

A
  1. adenocarcinoma
  2. adenosquamous carcinoma
  3. papillary adenocarcinoma

adenocarcinoma, adenosquamous carcinoma

17
Q

what is an adenocarcinoma?

what is a adenosquamous carcinoma?

what is a papillary adenocarcinoma?

A

tumor that contains benign squamous tissue along with malignant glands

tumor that contains malignant squamous cancer along with malignant cells

Highly aggressive cancer

18
Q

where does endometrial cancer spread?

where does it spread most commonly?

A

spreads into the cervix and uterine wall

most common site of spread are lungs

19
Q

how do you treat endometrial cancer?

A

hysterectomy and radiation

20
Q

what is a leiomyoma?

what is its other name?

its the most common tumor of what?

A

a benign tumor of smooth muscle cells.

myoma or fibroid

of the female genital tract

21
Q

leiomyomas are sensitive to what?

and what will that cause?

A

estrogen

Estrogen promotes:

  • its growth
  • Increase in size during pregnancy.
  • Decrease in size following menopause
22
Q

how does a leiomyoma look grossly?

what are the liomyoma types?

A

firm, pale-gray, with no encapsulation

(looks like a potato)

  1. intramural (within myometrium)
  2. subserosal (below the serosa)
  3. submucosal (below the mucosa of uterus)
23
Q

how does a leiomyoma look under the microscope?

A

interlascing fascicles of uniform spindle cells

24
Q

Leiomyomas commonly undergo what in dead or dying tissue?

A

dystrophic calcification and do not transform into leiomyosarcomas

25
Q

what are the clinical findings in a leiomyoma of the uterus? (fibroids)

A

usually asymptomatic but can manifest with:

  1. menorrhagia
  2. If large:
    1. intestinal bladder problems
    2. obstructive deliver
26
Q

what is a leiomyosarcoma?

is it caused by malignant transformation of leiomyoma?

A

a malignant tumor of smooth muscle cells of the uterus that arises de novo.

never

27
Q

leiomyosarcomas will show what features?

A

gross: poor, features of invasion
histo: pleomorphism and abnormal mitosis
mestastasis: yes

28
Q

describe in a leiomyoma these: gross, histo, metastasis

A

gross: well circumscribed
histo: uniform size and uniform nuclei
metastasis: no

Pathology 2 Block 2 (32 decks)

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