Female GU Pathology II: Uterus Flashcards
Consists of bundles of smooth muscle
Myometrium
Composed of endometrial glands and surrounding stroma, responsive to hormone stimulation, and undergoes monthly shedding
Endometrium
Endometritis
Inflammation of the endometrium
What is characteristic of acute endometritis?
Abnormal presence of neutrophils
What is characteristic of chronic endometritis?
Plasma cells are diagnostic
What are some possible causes of endometritis?
- Infection
- Abortion
- Delivery
- IUDs
- STDs
What are some complications of endometritis?
– Infertility
– Ectopic pregnancy
What are common causes of pelvic inflammatory disease?
- Chlamydia trachomatis
* Neisseria gonorrhoeae
What is the clinical presentation of PID?
Purulent cervical discharge, cervical motion tenderness
Endometriosis
Endometrium glands or stroma presents in abnormal locations outside the uterus
What is the pathogenesis of endometriosis?
Multiple theories but regurgitation is favored - Menstrual backflow though fallopian tubes leads to implantation with decreased immune clearance.
Adenomyosis
The presence of endometrial glands and surrounding stroma deep WITHIN the myometrium.
With what can “chocolate” cysts be seen in?
Endometriosis
What can be seen in the uterus with adenomyosis?
Uterus can enlarge due to myometrial hypertrophy
What is the main cause of endometrial hyperplasia?
Excess estrogen
What is the risk of endometrial cancer in nontypical endometrial hyperplasia?
Low risk
What is the risk of endometrial cancer in atypical endometrial hyperplasia?
High risk - this is AKA Endometrial Intraepithelial Hyperplasia
What is the clinical presentation of endometrial hyperplasia?
Abnormal uterine bleeding or postmenopausal bleeding
What is the most frequently altered gene in endometrial carcinoma?
PTEN
What is the most common invasive cancer of the female genital tract?
Endometrial Carcinoma
What is the most common type of endometrial carcinoma?
Endometrioid
What is the main risk factor for endometriod endometrial carcinoma?
Unopposed estrogen - many sources (obesity, early menarche, late menopause, DM, HTN)
What does serous endometrial carcinoma arise from?
Usually arises from atrophic endometrium
What is seen on histology of serous endometrial carcinoma?
Papillary Structures
What drug are endometrial polyps associated with?
Tamoxifen
A 37‐year‐old woman has had dysmenorrhea for 8 months. On pelvic examination the uterus appears symmetrically enlarged. This microscopic appearance is representative of her myometrium. Which of the following is the most likely diagnosis?
A. Adenomyosis B. Endometriosis C. Endometritis D. Invasive endometrioid carcinoma E. Invasive secretory carcinoma
A. Adenomyosis
Leiomyoma
Most common BENIGN tumor in females that arises from myometrial smooth muscle cells
What is the histological appearance of leiyomyomas?
Well-delineated, whorled bundles of smooth muscle cells, resembling the surrounding normal myometrium
Leiomyosarcoma
Uncommon tumors, arise de novo from either myometrial layer or endometrial stroma - do NOT arise from benign leiomyomas
What is the prognosis of leiomyosarcoma?
Poor
A 14‐year‐old girl has had irregular menstrual cycles for 6 months. She had menarche at age 12. There are no abnormal physical examination findings. An endometrial biopsy is taken on calculated post‐ ovulatory day 9 and shows proliferative phase endometrium. Which of the following is the most likely diagnosis?
A. Adenomyosis B. Anovulatory cycles C. Acute endometritis D. Endometrial adenocarcinoma E. Leiomyomata
B. Anovulatory cycles
What is the most common cause of abnormal uterine bleeding in adolescents?
Anovulatory Cycles
