endometrial conditions Flashcards
Endometrial polyp - definition/appearance
Well circumscribed collection of endometrial tissue within uterine wall. May contain smooth muscle cells
Endometrial polyp - location/presentation
- can extend into cavity in the form of polyp
- assymptomatic/painless abnormal uterine bleeding
Adenomyosis - definition/due to
Extension of endometrial tissue (grandular) into uterine myometrium. Caused by hyperplasia of basal layer
Adenomyosis - presentation
- dysmenorrhea
- menorrhagia
- uniformly enlarged, soft, globular uterus
Adenomyosis - treatment
- GnRH agonists
2. Hysterectomy
MC tumor in females
Leiomyoma (fibrinoid)
Leiomyoma (fibrinoid) - increased incidence in
- African ameriancs
- peak at 20-40
Leiomyoma (fibrinoid) - definition/gross appearance/transformation
benign SM tumor
multiple dicrete tumors
malignant transformation (leiomyosarcoma) is rare
Leiomyoma (fibrinoid) - pathophysiological characteristic
Estrogen sensitive –> increased tumor size in pregnancy and decreased with menopause
Leiomyoma (fibrinoid) - presentation
- asymptomatic
- abnormal uterine bleeding
- miscarriage
- iron deficiency anemia (if severe bleeding)
Endometrial hyperplasia - definition/mechanism
abnormal endometrial gland proliferation usually caused by excess estrogen stimulation
Endometrial hyperplasia - complications (and mechanism)
high risk for endometrial carcinoma - nuclear atypia is greater risk factor than complex (vs simple) architecture
Endometrial hyperplasia - presentation
postmenopausal vaginal bleeging
Endometrial hyperplasia - risk factors
- anovulatory cycles
- hormone replacement therapy
- polycystic ovarian sydrome
- granulosa cell tumor
Leiomyoma (fibrinoid) - histology
whorled pattern of of SM bundles with well demarcated borders
endometrial carcinoma - age
55-65
endometrial carcinoma typically preceded by
encometrial hyperplasia
endometrial carcinoma - present with
vaginal bleeding
endometrial carcinoma - risk factors
- prolonged use of estrogen without progestins
- obesity
- diabetes
- hypertension
- nulliparity
- late menopause
- Lynch syndrome
endometritis - definition/association
Inflammation associated with retained products of conception following delivery, miscarriage, abortion, or foreign body (IUD)
endometritis - mechanism
retained materials in uterus –> infection by bacterial flora from vagina or intestine tract
endometritis - treatment
gentamicin + clindamycin +/- ampicillin
Endometriosis - definition/location
non-neoplastic endometrial glands/stroma outside endometrial cavity. Can be anywhere –> MC at ovary (frequent bilateral), pelvis, peritoneum
Endometriosis in ovary
appears as edometrioma (blood-filled chocolate cyst)
Endometriosis may be due to
- retrorade flow (menstruation)
- metaplastic transformation of multipotent cells`
- trnasportation of endometrial tissue via lymphatic system
Endometriosis - uterus size
normal
Endometriosis - presentation
- cyclic pelvic pain
- bleeding
- dysmenorrhea
- Dysparenia
- pain with defacation
- infertility
endomtriosis - treatment
- NSAID
- OCP
- progestins
- GnRH agonists
- Danazol
- Laparoscopic removal
