Female genital pathology Flashcards
When do infections readily enter female genital tract?
oestrous and parturition
Where does ovarian cancer commonly implant?
Upon peritoneum
What are most repro tract inflammatory diseases from?
Asceding infections
How can pathogens enter the ReproT? 4
ASCENDING - commonest, at oestrous, post-partum, pregnancy (equine)
HAEMATOGENOUS - specific infections
DESCENDING FROM OVARY - rare, som eviral, chlamydial, ureaplasma infections
TRANSNEURAL - rare, herpes recrudescence
How do female hormones affect immunity?
OESTROUS: better drainage through open cervix
OESTROGEN: better disease resistance - ruminants upregulate BCs and TCs
PROGESTATIONAL/LUTEAL: uterus more susceptible to infection
Inflammation with epithelial and mucosal surface loss in the uterus results in decreased PGF2a production –> no CL lysis
How can sex be defined? 4
Genetic/chromosomal (xx/xy)
Gonadal (testis.ovary)
(ductal)
Phenotypic
List some examples of tract anomalies
segmental aplaisa (white shorthorn cattle)
pesistent hymen
duplication
Outline developmental cysts
Congenital
Peri- or intraovarian
Don’t confuse with functional cysts
List some acquired ovarian lesiosn
CYSTS:
follicular
anovulatory luteinised (luteal cysts)
cystic CL
HAEMORRHAGES
ADHESIONS
INFLAMMATION: oophooritis, rare, often ascending or systemic bacterial
What is a follicular cyst/ cystic ovarian (Graafian) follicle?
- feature/what?
- cause
- signs
FEATURE: Failure of mature follicle to ovulate (COD)
>2.5cm cow, >1 cm sow
Persistence for >10d without functional CL
CAUSE: Anovulation without luetinisation due to abnormality in HPAO axis
Lack of LH peak due to low GnRH or its Receptors
stress/infection (cortisol)
SIGNS: Anoestrous (esp sows) or nymphomania (cows)
How does a luteal cyst form?
anovulation with luteinisation of theca (likely delayed or insufficient LH peak)
Treatment of luteal cysts?
PGF2a
What can cystic corpora lutea be confused with?
luteal cysts (because large and firm)
List the types of ovarian neoplasm - 4
GERM CELL NEOPLASM (rare): dysgerminoma, teratoma
GONADAL STROMAL NEOPLASM: granulosa cell tumour, thecoma, luteoma
EPITHELIAL NEOPLASM: cystadenoma, cystadenocarcinoma
SECONDARY TUMOURS: lymphoma, mammary carcinoma (bitch), intestinal carcinoma (4)
What is a dysgerminoma?
origin
appearance
aggressive
ORIGIN: from primitive germ cells (male analogue = seminoma)
APPEARANCE: smooth surface, commonly haemorrhagic/necrotic areas, frequent mitotic figures and germ cells
AGGRESSIVE: mostly benign and undifferentiated
What is a teratoma?
ORIGIN
APPEARANCE
AGGRESSION
ORIGIN: totipotential germ cells with elements of 2-3 germinal layers (commonly including skin)
APPEARANCE: mostly well-differentiated
AGGRESSION: benign
Granulosa-theca cell tumour:
PRODUCT
APPEARANCE
AGGRESSION
PRODUCE: steroids (some)
APPEARANCE: smooth surface with solid or cystic cut surface
AGGRESSION: usually benign
Epithelial neoplasms:
APPEARANCE
SPREAD
CONSEQUENCE
APPEARANCE: often bilateral and shaggy/cauliflower-like surface, especially in bitches
SPREAD: by implantation on peritoneal surfaces (= contact metastases, all ovarian neoplasms)
CONSEQUENCE: ascites (sometimes)
What can happen to the uterine tubes? 3
Which species?
HYDROSALPINX (congenital or acquired)
PYOSALPINX
SALPINGITIS
Species: gilts in first pregnancy, otherwise rare
What can happen to the uterus?
PHYSICAL CHANGES:
Torsion
Rupture
Prolapse
What can uterine prolapse be associated with? 3
hypocalcaemia oestrogen excess (plants) prolonged dystocia
List 3 examples of endometrial growth disturbance
Hyperplasia/CEM (i.e. due to excessive and prolonged oestrogenic stimulation, endogenous/exogenous)
Mucometra/hydrometra
Pseudopregnancy
What is the pathological definition/difference between metritis and endometritis
the days after pregnancy that it occurs
What is endometritis?
Uterine mucosa only
WHEN: Post-service, post-partum (dystocia)
RESULT: inflammatory infiltrate to mucosa, self-limiting if mild, severe –> chronic/fibrous
CAUSE: persistent CL (mare) and cow in chronic endometritis.
What are common pathogens causing endometritis in COWS? 4
PREGNANCY:
Herpes
Tritrichomonas foetus
Campylobacter foetus ssp venerealis
Others (environmental) - pyogenic cocci and coliforms, T.pyogenes
What are common pathogens to cause endometritis in mares? 5
alpha-haemolytic streptococci Klebsiella pneumoniae E.coli Taylorella equigenitalis (CEM) Pseudomonas aeruginosa
Appearance of metritis
commonly dull congested serosa with ‘paintbrush’ haemorrhages, thickened oedematous friable uterine wall, yellowish-dark red exudate with foul odour, rarely ruptures
What are causes of pyometra in bitches (queen)?
older nulliparous
Infection supervening upon CEH
usually a few weeks after oestrous under P4 exposure following oestrogen priming
bacterial infection (endometrium)
UTI
Pathogens: E.coli (brownish viscous exudate), Strep sp (creamy yellowish exudate)
Cervix: open/closed
What is the result of pyometra if untreated?
toxaemia/bacteraemia common, widespread extra-medullary haematopoiesis and immuno-complex glomerulopathy leading to kidney failure
Pyometra - cows WHY WHEN SIGNS COMMON PATHOGENS
WHY: uterine disease predisposes pyometra, persisting CL and high P4 levels
WHEN: mostly early post-partum (following endometritis/metritis), various times after breeding (venereal)
SIGNS: functional cervical closure, usually some discharge (few ml to several L, thick, mucinous, cream or grey pus), rarely systemic signs
PATHOGENS: haemolytic streptococci, staphylococci, coliforms, Trueperellla pyogenes, Pseudomonas sp, also Tritrichomonas foetus (venereal)
What is the usual isolate from pyometra in the sow?
Trueperella pyogenes
Pyometra - mares
WHEN
COMMON PATHOGENS
WHEN: after dystocia with infections (some)
WHAT: cycling continues, sometimes prolonged, hormonal influences less important, mostly no cervical closure (commonly cervical deformity) –> discharge, seldom evidence of systemic disease
PATHOGENS: Streptococcus zooepidemicus, E.coli, Actinomyces spp, Pasteurella spp, Pseudomonas spp.
What neoplasms can affect the uterus? 3
LEIOMYOMA
CARCINOMA
LYMPHOSARCOMA
Outline uterine leiomyoma
mostly bitch and benign
often multiple - also affecting cervix/vagina
oestrogens likely involved in provoking and maintaining in bitch
usually firm, pink, white, whorled SMCs
Outline uterine carcinomas
mainly cow (found at meat inspection - consider enzootic bovine leukosis, EBL which is notifiable)
mainly uterine horns
scirrhous response (firbous), firm
metastases to regional LNs, lungs, peritoneum (seeding)
Outline uterine lymphosarcoma
EDL in cow is notifiable
TETRAD of affected organs (heart, abomasum, LNs, uterus)
Light yellow, slightly friable
T/F: all neoplasias in adult cows are notifiable except haemangiosarcoma and papilloma.
True
How can the vulva and vagina be affected? 3
NON-INFLAMMATORY DISEASES
INFLAMMATORY DISEASES
NEOPLASMS
List some non-inflammatory diseases of the vulva/vagina
Persistent hymen Vaginal septum Ruptures Stricture/stenosis Abnormal tumefaction (swelling and increased size) Vaginal hyperplasia/hypertrophy/prolapse Vaginal cysts Vaginal polyps (older bitches)
What are some inflammatory diseases of the vulva/vagina?
Post-partum trauma
granular vaginitis/vulvitis
Herpes –> IPV/BHV-1, CHV-1, EHV-3/coital exanthema
Dourine - notifiable
Which neoplasms can affect the vulva/vagina?
Leiomyoma (like uterus)
TVT
Fibropapilloma
Squamous cell carcinoma of vulva
Why are TVTs unusual?
59 chromosomes instead of normal 78 in dogs
Outline TVT: Transmission Location Histopathology Treatment Prognosis
TRANSMISSION: transfer of neoplastic cells during coitus
LOCATION: nodule formation beneath vaginal mucosa that enlarges
HISTOPATHOLOGY: large, round neoplastic cells with occasional large bizarre nuclei
TREATMENT: vincristine -responsive
PROGNOSIS: metastases in dogs with poor health
