Female Pathology Flashcards
Endometrium & Myometrium
Proliferative endometrium
Proliferative endometrium – Mitosis
Endometritis
Inflammation of endometrium (acute/chronic)
Due to PID, retained POC, IUD
Plasma cells in endometrial stroma
Endometrial Polyps
Benign biphasic neoplastic growth (glands and stroma)
Dysfunctional bleeding
Most common +/- menopause
6p21
Endometriosis
Presence of endometrial glands and stroma outside of uterus
Cyclic bleeding
Can become blood filled cysts (chocolate cysts)
Discharge of blood leads to reactive changes, fibrosis and adhesions
Histology = Endometrial glands + stroma +/- hemosiderin
Adenomyosis
Growth of endometrium in the myometrium
Enlarged, nodular myometrium
Abnormal uterine bleeding; infertility
Endometrial hyperplasia
Exaggerated endometrial proliferation
Glands/stroma >50%
Abnormal glandular architecture
From prolonged/excess estrogen (obesity, anovulation, estrogen producing tumors)
Endometrial Adenocarcinoma
Endometrial hyperplasia without atypia –> 5% risk of progression to carcinoma
Endometrial hyperplasia with atypia –> 20-50% risk of carcinoma
Development of Type I Endometrial Carcinoma
In the background of endometrial hyperplasia
Low grade endometrioid and mucinous adenocarcinoma
Estrogen dependent
Hyperplasia carcinoma sequence
Mutation in mismatch repair, tumor suppressor gene (PTEN) – early in stepwise development
Endometrial Carcinoma Type II
Usually in an atrophic background
Independent of endometrial hyperplasia
Older women, more aggressive
Leiomyoma
Most common benign tumors in females (35-50%)
Usually asymptomatic
Abnormal bleeding
Usually multiple. sharply demarcated tumors
Submucosal, intramural and subserosal
Monoclonal proliferation of smooth muscle cells
Leiomyosarcoma
De novo from myometrial mesenchymal cells
Post menopausal
Solitary
Soft, hemorrhagic necrotic mass
Tumor necrosis, cytological atypia and mitosis
Recurrence and metastasis common
