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Pathoma Bina > Female Pathology: Endometrium and Myometrium > Flashcards

Female Pathology: Endometrium and Myometrium Flashcards

1
Q

What is endometrium

A

mucosal lining of uterine cavity

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2
Q

what is myometrium

A

smooth muscle wall underlying endometrium

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3
Q

what hormone drives the growth of endometrium during each phase?

A

proliferative phase: estrogen
secretory phase: progesterone
menstrual phase: loss of progesterone

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4
Q

what is asherman syndrome

A

secondary amenorrhea due to loss of basalis and scarring

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5
Q

clinical presentation of asherman syndrome

A

overaggressive dilation and curettage (D&C)

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6
Q

What is anovulatory cycle

A

lack of ovulation

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7
Q

what is wrong in the phases in anovulatory cycle

A

proliferative phase: estrogen driven

secretory phase: no progesterone, proliferative glands break down and shed resulting in uterine bleeding

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8
Q

anovulatory cycle’s dysfunctional bleeding usually occurs under what circumstances

A

menarche

menopause

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9
Q

what is acute endometritis

A

bacterial infection of the endometrium

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10
Q

clinical presentation for acute endometritis

A

fever
abnormal uterine bleeding
pelvic pain

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11
Q

what can cause bacterial infection in acute endometritis

A

retained products of conception

after delivery or miscarriage

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12
Q

what is chronic endometritis

A

chronic inflammation of endometrium

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13
Q

what causes chronic endometritis

A

retained products of conception
chronic pelvic inflammatory disease ( chlamydia )
IUD
TB

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14
Q

clinical features of chronic endometritis

A

abnormal uterine bleeding, pain and infertility

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15
Q

what cells characterize chronic endometritis? which one is diagnositc

A

lymphocytes and plasma cells ( diagnostic)

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16
Q

what is endometrial polyp

A

hyperplastic protrusion of endometrium

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17
Q

clinical presentation of endometrial polyp

A

abnormal uterine bleeding

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18
Q

what drug can give an endometrial polyp. MOA of drug

A

Tamoxifen

  • anti-estrogen effects on breast
  • weak pro-estrogenic effects on endometrium
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19
Q

What is endometriosis

A

endometrial glands and stroma outside of uterine endometrial lining

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20
Q

endometriosis is commonly due to what

A

retrograde menstruation with implantation at an ectopic site

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21
Q

clinical presentation of endometriosis

A

dysmenorrhea
pelvic pain
may cause infertility

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22
Q

dysmenorrhea

A

pain during menstration

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23
Q

what are changes in cycles for endometriosis

A

normal cyces

24
Q

what is the most common site of involvement for endometriosis? what does it form?

A

ovary

“chocolate cyst”

25
Q

other sites of involvement for endometriosis and their clinical features

A 
uterine ligament (pelvic pain)
pouch of douglas ( pain with defecation)
bladder wall ( pain with urination) 
bowel serosa ( abdominal pain and adhesions)
fallopian tube mucosa ( scarring increases risk for ectopic pregnancy)
26
Q

typically implants in endometriosis classically look like what

A

yellow-brown ‘gun-powder- nodules

27
Q

in endometriosis, involvement of uterine myometrium is called

A

adenomyosis

28
Q

what are the risks at site of endometriosis

A

carcinoma

29
Q

What is endometrial hyperplasia

A

hyperplasia of endometrial glands relative to stroma

30
Q

What causes endometrial hyperplasia

A

unopposed estrogen

  • obesity
  • PCOS
  • estrogen replacement
31
Q

clinical presentation of endometrial hyperplasia

A

postmenopausal uterine bleeding

32
Q

what patterns are seen in histo for endometrial hyperplasia

A
  • simple or complex

- presence or absence of cellular atypia

33
Q

what type of histo is an important predictor for progression to carcinoma in endometrial hyperplasia

A

presence of cellular atypia

34
Q

what is the most common invasive carcinoma of female genital tract

A

endometrial carcinoma

35
Q

what is endometrial carcinoma

A

malignant proliferation of endometrial glands

36
Q

clinical features of endometrial carcinoma

A

postmenopausal bleeding

37
Q

what are two pathways endometrial carcinoma arises

A

hyperplasia or sporadic

38
Q

in hyperplasia pathway, endometrial carcinoma arises from what

A

endometrial hyperplasia

39
Q

in sporadic pathway, endometrial carcinoma arises from what

A

atrophic endometrium with not evident precursor lesion

40
Q

what are risk factors for hyperplasia endometrial carcinoma

A 
estrogen exposure 
early menarche/late menopause 
nulliparity 
infertility 
anovulatory cycles 
obesity
41
Q

At what age does hyperplasia endometrial carcinoma present

A

60s

42
Q

his for hyperplasia endometrial carcinoma

A

endometrioid ( normal endometrium-like)

43
Q

at what age does sporadic endometrial carcinoma present

A

70s

44
Q

histo for sporadic endometrial carcinoma

A

serous
papillary structure
psammoma body formatoin

45
Q

what genetic mutation is present in sporadic endometrial carcinoma

A

p53 mutation

46
Q

What is the most common tumor in females

A

leiomyoma (fibroids)

47
Q

what is leiomyoma (fibroids)

A

benign neoplastic proliferation of smooth muscle arising from myometrium

48
Q

what is cause of leiomyoma (fibroids)

A

estrogen exposure

  • premenopausal women
  • enlarge during pregnancy , shrink after menopause
49
Q

what is gross exam for leiomyoma

A

multiple-well-defined, white, whorled masses

50
Q

clinical symptoms for leiomyoma

A

usually asymptomatic

  • abnormal uterine bleeding
  • infertility
  • pelvic mass
51
Q

what is leiomyosarcoma

A

malignant proliferation of smooth muscle arising from the myometrium

52
Q

do leiomyosarcoma arise from leiomyomas

A

no

53
Q

who usually gets leiosarcoma

A

postmenopausal women

54
Q

gross exam for leiomyomoas

A

single lesion with areas of necrosis and hemorrhage

55
Q

histo features of leiomyomas

A

necrosis
mitotic activity
cellular atypia

Pathoma Bina (38 decks)

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