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Reproductive System > Female Pathology - Uterus > Flashcards

Female Pathology - Uterus Flashcards

1
Q

How can the functional endometrium be subdivided?

A
  • Secretory endometrium
    • Tortuous secretory glands + pseudodecidualized stroma
  • Proliferative endometrium
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2
Q

What conditions can affect the uterine body?

A
  1. Inflammation/endometritis/pelvic inflammatory disease
  2. Polyps
  3. Adenomyosis
  4. Leiomyomas
  5. Premalignant (hyperplasia)
  6. Malignancies
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3
Q

What is common between the conditions that affect the uterine body?

A

All uterine body conditions may lead to dysfunctional and/or abnormal bleeding

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4
Q
  1. What is endometritis?
  2. What can cause it?
  3. What can be seen in the stroma?
A
  1. Inflammation of Endometrium
    • Acute/Chronic
  2. Due to:
    • PID
    • Retained POC
    • IUD
  3. Plasma cells in the endometrial stroma
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5
Q

Endometrial Polyps

  • Definition:
  • Clinical Signs:
  • Prevalence:
  • Immunohistochemistry:
  • Polyp Type:
  • Appearance of glands:
A
  • Benign biphasic neoplastic growth (glands and stroma)
  • Dysfuntional bleeding
  • Most common ± menopause
  • Rearrangement of 6p21
  • Intrauterine sessile or pedunculated growth
  • Dilated glands
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6
Q

Endometriosis:

  • Definition:
  • Clinical Signs:
  • Characteristic Finding:
  • Discharge of blood leads to ….
  • Histology:
A
  • Presence of endometrial glands and stroma outside of uterus
  • Cyclic bleeding
  • Can become blood filled cysts (chocolate cyst)
  • Discharge of blood leads to reactive changes, fibrosis and adhesions
  • Histology:
    • Endometrial glands + stroma
    • ± hemosiderin
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7
Q
  • What is adenomyosis?
  • What are the histological changes?
  • What is the clinical sign?
A
  • Growth of endometrium in the myometrium
  • Histology:
    • Enlarged, nodular myometrium with cysts
    • Hemorrhagic cysts in functional endometrium
  • Clinical Signs:
    • Abnormal uterine bleeding
    • Infertility
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8
Q

What can cause endometrial disorders?

A
  1. hyperplasia
  2. prolonged/excess estrogen
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9
Q

What defines endometrial hyperplasia (4)?

A
  1. Exagerated endometrial proliferation
  2. Abnormal glandular architecture
  3. Increase gland/stroma ratio ( > 1:1)
  4. Nuclear atypia
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10
Q

What can lead to prolonged/excess estrogen (3)?

A
  1. Obesity
  2. Anovulation
  3. Estrogen producing tumors
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11
Q

What changes are seen in endometrial adenocarcinoma?

A
  1. Back to back glands
  2. Cellular atypia
  3. Abundant mitosis, including abnormal forms
  4. Necrosis
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12
Q

What are the risk factors for endometrial disorders?

A
  • Obesity
  • Diabetes
  • Hypertension
  • Infertility
  • Exposure to unopposed estrogen
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13
Q

Is there a risk for adenocarcinoma if endometrial hyperplasia is present?

A

Yes

  • 5% risk of progression to carcinoma in hyperplasia without atypia
  • 20%-50% risk of carcinoma in hyperplasia with atypia
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14
Q

Type I Endometrial Adenocarcinoma:

  • Endometrial hyperplasia association?
  • Grade:
  • Estrogen dependence?
  • Progression:
  • Mutation:
A
  • In a background of endometrial hyperplasia
  • Low grade endometrioid and mucinous adenocarcinoma
  • Estrogen dependent
  • Progression:
    • Hyperplasia-carcinoma sequence
  • Mutation in Mismatch repair (HNPCC) ;
    • tumor suppressor gene PTEN (Cowden syndrome)
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15
Q

Type II Endometrial Adenocarcinoma

  • Association with endometrial hyperplasia?
  • Mutation:
  • Demographics:
A
  • Usually in a atrophic background
    • Independent of endometrial hyperplasia
  • p53 mutation
  • Older women; more aggressive
    • High grade endometrioidcarcinoma
    • Serous carcinoma
    • Clear cell carcinoma
    • Carcinosarcoma
    • Undifferentiated
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16
Q

What is also known as fibroids?

17
Q

Leiomyoma

  • Prevalence:
  • Symptoms:
  • Apperance:
  • Pathogenesis:
A
  • Most common benign tumors in females (35%-50%)
    • Blacks > whites
  • Asymptomatic, usually
    • Abnormal bleeding
  • Sharply demarcated tumors
    • Usually multiple
    • Submucosal, intramural and subserosal
  • Monoclonal proliferation of smooth muscle cells (bundles of benign smooth muscle)
18
Q

What is the relation between leiomyoma and leiomyosarcoma?

A

**No relation**

19
Q

Leiomyosarcoma

  • Pathogenesis:
  • Demographics:
  • Appearance:
  • Pathological Diagnostic Features:
  • Recurrence and Metastasis?
A
  • De novo from myometrialmesenchymal cells
  • Post menopausal
  • Solitary
    • Soft, hemorrhagic, necrotic mass
  • Pathological Diagnostic Features
    • Tumor necrosis, cytological atypiaand mitosis (abnormal forms)
  • Recurrence and metastasis are common
    • Pelvis, lungs, bones

Reproductive System (35 decks)

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