Gynae Pathology Flashcards
identify this and how to describe it
lichen sclerosus
- atrophic plaques
- intense puritus (itch)
who is lichen sclerosus usually found in, and where
post menopausal women at the anogenital area
what could lichen sclerosus lead to? (one malignant, and one worse rash)
- chronic inflammatory disease
- chronic scratching leads to lichen simplex chronicus
- could lead to** squamous cell carcinoma**
what is this condition, and what is it caused by?
vaginal agenesis (no vagina)
- due to lack of mullerian duct development
what pathology of the fallopian tubes is here and what does it arise from
hyatids of morgagni (paratubual cyst)
arises from remants of the mullerian duct
identify this pathology and some causes of it
(there is fluid in the fallopian tubes)
hydrosalpinx
(fluid filled fallopian tube)
PID and endometriosis
what organisms cause PID
1.** chlamydia trachomatis **
2. neisseria gonorrhoea
hydrosalpinx vs pyosalpinx
fluid filled vs pus filled
what are inflammed fallopian tubes called?
salpingitis
salpinx~ :tube
itis:inflammation
isthmus
interstitum
inter –> in the middle of (it is the connection between the fallopian tube and the womb)
what condition is more likely in women with IUDs?
actinomyotic salpingitis
- caused by actinomyces israeelii
- shows gram + organism
what is the most common ovarian mass in young women?
follicular cysts
what are follicular cysts caused by?
graffian follicle fails to rupture
= continues to grow
= develops into large cysts with granulosa cells
how does hyperinsulinema lead to hyperplasia and hyperpigementation?
insulin resistance
= more IGF-1 produced
= increased melanocyte and keratinocyte proliferation
= hyperplasia and hyperpigmentation
what are multiple follicular cysts also known as?
polycystic ovary syndrome
what are corpus lutheal cysts caused by?
build up of fluid in corpus lutheum
= enlargement of CL
= produce excess progestrone
= delay mences
= menstrual irregularities
what are the 3 layers of the uterine wall?
(inner)
endometrium
MYOmetrium
PERImetrium
(outer)
what cells is the endometrium lining made out of?
simple columnar epithelium (contains microvilli to push the egg around)
what is the most common benign tumour of the endometrium
endometrial hyperplasia
- COMPLEX hyperplasia (with atypia)
- SIMPLE hyperplasia (no atypia)
what is the histological presentation of complex vs simple hyperplasia?
COMPLEX: (high risk of carcinoma)
- glandular crowding
- epithelial stratification
- loss of PTEN gene
SIMPLE: (low risk of carcinoma)
- dilated glands
fibroids vs cysts
fibroids: uterus
cysts: ovaries
what is the most common UTERINE neoplasm in young women?
leiomyoma
which carcinoma does endometriosis increase the risk of, and why?
clear cell carcinoma
endometriosis
= ectopic endometrial tissue
= chronic inflammation
= increase risk of mutations
= CCC
why does obesity increase the risk of PCOS?
obesity
= increase adipose tissue
= increase peripheral estrogen
= PCOS risk increases
what is this pathology
adenomyosis
what is adenomyosis characterised by?
hyperplasia of endometrial basal layer
= etopic endometrial deposits in the myometrium
what types of adenomyosis are there, and which one is more common?
diffuse and localised type
diffuse adenomyosis is more common
what is the most common neoplasm (tumour) of the fallopian tube, and how to describe it?
adenomaTOID tumour
it is a tumour of the visceral mesothelial layer
= usually asymptomatic
**low yield
what are the histological findings of adenomaTOID tumours?
- tubular spaces of varying sizes
- flattened cells in desmoplastic stroma (desmoplastic = formation of fibrous tissue)
what does endometriosis affecting the fallopian tubes result in?
salpingitis isthmica nodosa + hydrosalpinx
= increased probability of infertility
salpingitis = inflammation of the fallopian tubes
isthmica = at the isthmus
nodosa = formation of nodules
what is the most common type of ovarian tumour?
epithelial ovarian tumours
**think of the ovary as a grape
- epithelial (skin)
2.sex cord/ stromal (flesh) - germ cell (seed)
What possible neoplasms can occur at these 3 levels?
epithelium:
1. cystadenoma - mucinous and serous (benign, borderline or malignant)
2. brenner tumour
3. Clear cell carcinoma
- Endometrioid carcinoma
stroma
1. ovarian fibroma
2. thecoma
3. stertoli-leydig cell tumour
4. Granulosa cell tumor
germ cell:
1. teratoma
2. Dysgerminoma
3.yolk sac tumor
4. Choriocarcinoma
