Endometrial Pathology

Question 1

This is the most common type of gynecologic malignancy.

Answer 1

endometrial carcinoma

Question 2

75-80% of endometrial cancer happens in __ women.

Answer 2

postmenopausal

Question 3

Associated risk factors for endometrial carcinoma include…

Answer 3

1. obesity/anovulatory cycles
2. postmenopausal (esp on HRT)
3. hx of atypical hyperplasia
4. hx of tamoxifen therapy
5. family hx of uterine cancer

Question 4

This is the first indication of that endometrial cancer has spread.

Answer 4

myometrial invasion

Question 5

Without treatment, endometrial cancer will spread to…

Answer 5

the cervix, adnexa, tubes, and ovaries.

Question 6

Distant mets may occur if the pelvic __ is infiltrated.

Answer 6

lymphatic system

Question 7

What are three clinical signs of endometrial cancer?

Answer 7

1. postmenopausal vaginal bleeding
2. menopausal hypermenorrhea
3. uterine distention pain

Question 8

Sonographically, endometrial cancer appears an increased uterine __, alteration in uterine __ ,__ in the endometrial cavity, and a __ endometrial stripe.

Answer 8

size, parenchyma, fluid, thick heterogeneous

Question 9

This is a proliferation of endometrial glandular tissue.

Answer 9

endometrial hyperplasia

Question 10

T/F? Endometrial hyperplasia is not invasive.

Answer 10

true

Question 11

T/F? Endometrial hyperplasia involves the entire endometrium.

Answer 11

Not necessarily. It can be diffuse or focal.

Question 12

T/F? Endometrial hyperplasia is a precursor to cancer.

Answer 12

true, about 25%

Question 13

This is a common cause of abnormal uterine bleeding.

Answer 13

endometrial hyperplasia

Question 14

Endometrial hyperplasia may be caused by…

Answer 14

1. unopposed estrogen therapy
2. anovulatory cycles
3. PCOS
4. Obesity
5. granulosa cell & thecoma tumors

Question 15

Ideally, when should the ultrasound to examine a possible hyperplasia case be?

Answer 15

at the beginning of a hormone cycle (immediately post-menstrual)

Question 16

How can we tell endometrial carcinoma from hyperplasia?

Answer 16

histologic examination

Question 17

Sonographically, endometrial hyperplasia has __ borders with a __ texture.

Answer 17

smoother, homogeneous but possibly cystic

Question 18

How large do we expect the endometrial cavity to be in a premenopausal woman with hyperplasia?

Answer 18

greater than 14 mm

Question 19

How large do we expect the endometrial cavity to be in a postmenopausal woman with hyperplasia?

Answer 19

greater than 5 mm

Question 20

How large do we expect the endometrial cavity to be in a premenopausal woman on estrogen with hyperplasia?

Answer 20

up to 8 mm

Question 21

This is a localized overgrowth of endometrial tissue.

Answer 21

Endometrial polyps

Question 22

What imaging technique is ideal for demonstrating endometrial polyp size and location?

Answer 22

sonohysterography

Question 23

Clinical signs for a endometrial polyp?

Answer 23

1. infertility
2. abnormal uterine bleeding
3. occasionally postmenopausal bleeding

Question 24

T/F? Endometrial polyps are usually symptomatic.

Answer 24

FALSE, asymptomatic

Question 25

T/F? Endometrial polyps are usually discovered during a D&C.

Answer 25

true

Question 26

Sonographically, endometrial polyps appear as a mass that is __ and might have a __.

Answer 26

discrete, focal, round, echogenic; vascular stalk

Question 27

T/F? Endometrial polyps may be indistinguishable from hyperplasia.

Answer 27

true

Question 28

Sonohysterography is also known as…

Answer 28

SIS (saline infused…) or hysterosonography

Question 29

This is a real time ultrasound during the injection of sterile saline into the uterine cavity.

Answer 29

SIS

Question 30

Indications for SIS…

Answer 30

1. infertility and habitual abortion
2. congenital uterine abnormalities/variations
3. pre- and postoperative eval
4. suspected uterine cavity synechiae