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ENRP > Endometrium > Flashcards

Endometrium Flashcards

1
Q

What does the endometrium contain during the proliferative phase
(days 0-14)?

A

Tubular glands with pseudostratification

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2
Q

What does the endometrium contain during the early secretory phase?

A

Piano key vacuoles

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3
Q

What does the endometrium contain during the late secretory phase?

A

Tortuous and serrated glands with secretory material

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4
Q

What does the endometrium contain during menses?

A

Tight clusters of stromal cells

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5
Q

Abnormal uterine bleeding can be due to anovulatory cycles. What are 3 conditions that can have this?

A

PCOS - ovarian lesions
Obesity
Endocrine disorders

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6
Q

When does Acute Endometritis occur and what is it?

A

After delivery of a baby – bacterial infection

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7
Q

What histo change will be present with Acute Endometritis?

A

Neutrophils destroy endometrial epithelium +/- microabscesses

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8
Q

What are 3 symptoms of Acute Endometritis?

A

Post-partum fever
Abdominal pain
Uterine tenderness

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9
Q

What are some causes of Chronic Endometritis?

A

PID
IUD (actinomyces)
Retained conception products

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10
Q

What histo change will be present with Chronic Endometritis?

A

Plasma cells in stroma

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11
Q

What are the symptoms of Chronic Endometritis?

A

Asymptomatic or bleeding/cramping

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12
Q

What is Endometriosis?

A

Endometrial tissue OUTSIDE the uterus

– usually at ovaries and pelvic tissues

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13
Q

What are some symptoms of Endometriosis?

A

Dysmenorrhea (pain with menses)
Ovarian mass
Pain with sex
Infertility

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14
Q

Severe Dysmenorrhea, pain with sex, ovarian mass and infertility is likely?

A

Endometriosis

- endometrial tissue outside the uterus

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15
Q

What 3 mechanisms allow for survival of endometrial tissue with Endometriosis?

A
  1. Inflammatory factors
  2. Increased aromatase enzyme => increased estrogen
  3. Mutations in tumor genes
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16
Q

What type of lesions are present with Endometriosis?

A

“powder-burn” lesions

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17
Q

What histo changes are needed to diagnose Endometriosis?

A

Need 2/3:

  1. Endometrial glands
  2. Endometrial stroma
  3. Hemosiderin laden macrophages – evidence of hemorrhage
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18
Q

Adenomyosis

A

Endometriotic tissue in the myometrium

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19
Q

What condition has the same symptoms as Endometriosis?

A

Adenomyosis

- endometriotic tissue in the myometrium

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20
Q

What factors can increase endometrial polyp formation and what is an example?

A

Proestrogenic factors – Tamoxifen

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21
Q

What is Endometrial hyperplasia?

A

Increased endometrial glands

22
Q

Typical Endometrial Hyperplasia

A

Glandular crowding

– slight risk of carcinoma

23
Q

Atypical Endometrial Hyperplasia

A

Nuclear atypia

– substantial risk of carcinoma

24
Q

What are the risk factors for Endometrial Hyperplasia/Carcinoma/

A

Chronic unopposed ESTROGEN

  • Obesity, PCOS
  • Early menarche, late menopause and no pregnancies
25
Q

What is the main risk factor for Endometrial hyperplasia/carcinoma?

A

Chronic unopposed estrogen

26
Q

What is pro-estrogen in the uterus but anti-estrogen in the breast?

A

Tamoxifen

27
Q

What is the main symptom with Endometrial Carcinomas?

A

Abnormal uterine bleeding

28
Q

When does Type 1 Endometrial Carcinoma occur compared to Type 2/

A

10 years earlier

29
Q

What is type 1 Endometrial Carcinoma?

A

Endometrioid

30
Q

What is the risk factor for Type 1 Endometrial Carcinoma?

A

Unopposed Estrogen

– also obesity

31
Q

What is the precursor lesion with Type 1 Endometrial Carcinoma?

A 
Endometrial Hyperplasia 
(increased glands)
32
Q

What 3 genes are often involved in Type 1 Endometrial Carcinomas?

A

PTEN
P13K/AKT
MSI

33
Q

What are the 2 options for Type 2 Endometrial Carcinomas?

A
  • serous

- malignant mixed mullerian tumor

34
Q

What are the risk factors for Type 2 Endometrial Carcinomas?

A

Age and BLACK people post menopause atrophy

35
Q

What gene is often involved with Type 2 Endometrial Carcinoma?

A

TP53

36
Q

Which type of Endometrial Carcinoma has the WORSE prognosis?

A

Type 2

– serous/malignant mixed mullerian tumor

37
Q

How is Lynch syndrome inherited?

A

AD

38
Q

What is there a mutation in with Lynch syndrome?

A

Mismatch repair gene (mlh1/msh2)

39
Q

What does the mutation in mismatch repair genes with Lynch Syndrome give rise to?

A

Microsatellite Instability (MSI)

40
Q

What does lynch syndrome increase your risk for?

A

Colorectal cancer

Endometrial and ovarian cancers

41
Q

Adenosarcomas can be mistaken for a polyp. What are they?

A

Benign glands + malignant stroma

42
Q

Low grade endometrial stromal sarcoma is a malignant tumor of the stroma. What can it invade?

A

Myometrium and/or lymph and vascular

43
Q

What gene translocation is found with a low grade endometrial stomal sarcoma?

A

JAZF1

44
Q

What are 2 Myometrial Tumors?

A
  1. Leiomyoma

2. Leiomyosarcoma

45
Q

Leiomyoma

A

Benign myometrial tumor

46
Q

How do Leiomyomas look?

A

Tan-white circumscribed nodules

47
Q

Leiomyomas are usually asymptomatic. What mutation can be present?

A

MED12 mutation

48
Q

Leiomyosarcoma

A

Malignant myometrial tumor

49
Q

How do Leiomyosarcomas look?

A

Bulky fleshy mass

50
Q

What 3 histo changes differentiate a Leiomyosarcoma from a Leiomyoma?

A
  1. Atypia
  2. Increased mitoses
  3. Tumor necrosis

ENRP (45 decks)

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