L1 & L2 - Pathology of the Female Reproductive Tract 1 & 2 Flashcards
What type of epithelium in vulva and vagina?
Stratified squamous epithelium
Vagina at puberty
Oestrogen secreted by the ovary stimulates maturation of squamous epithelial cells
Glycogen is formed within mature squamous epithelial cells
Glycogen in cells shed from the surface is substrate for vaginal anaerobic organisms (dominated by lactobacilli)
Lactobacilli produce lactic acid keeping vaginal pH below 4.5
3 parts of cervix
Ectocervix
Endocervix
Transformation zone
Ectocervix formed of
stratified squamous epithelium
Endocervix formed of
single layer of tall, mucin producing columnar cells
Endocervix has a large SA due to
Columnar epithelium lines tiny blind ending channels (‘clefts’)
These radiate out from the endocervical canal into the surrounding stroma
What type of epithelium lines the endocervix?
columnar epithelium
What is the junction between the ecto and endocervix called?
Squamo-columnar junction
Formation of the transformation zone
During puberty the cervix changes shape
The lips of the cervix grow
The distal end of the endocervix opens
Endocervical mucosa becomes exposed to the vaginal environment
Describe the process of squamous metaplasia (transformation zone)
The distal endocervical columnar epithelium is exposed to the acidic vaginal environment
It is not suited to this, so undergoes an adaptive change called metaplasia
Reserve cells in this area proliferate and mature to form squamous epithelium: This process is called squamous metaplasia
Define metaplasia
A transformation of cell type from one kind of mature differentiate cell type to another kind of mature differentiated cell type
Describe how the characteristics of the metaplastic squamous epithelium change over time
At first, the metaplastic squamous epithelium is thin and delicate (lots of proliferation and maturation is incomplete)
With time, the metaplastic epithelium comes to be as strong and well formed as that on the ectocervix
What is the myometrium?
Bundles of smooth muscle, vasculature and nerves
Endometrium: proliferative phase (before ovulation)
Tubular glands
Specialised stroma
Blood vessels
Mitoses in glands
Endometrium: secretory phase
Cork screw glands
Specialised stroma
Blood vessels
Secretions in glands
Define neoplasia
‘New growth’ - abnormal, uncoordinated and excessive cell growth
Persists following withdrawal of stimulus and associated with genetic alterations
Nomenclature of neoplasms
Different neoplasms have different behaviour
Accurate identification and naming therefore important for treating the patient
How are neoplasms classified?
According to their behaviour and histogenesis
Behaviour: benign or malignant
Histogenesis: recognising the cell of origin
Benign neoplasms
Remains localised and doesn’t invade surrounding tissues
Generally grow slowly
Good resemblance of parent tissue
Leiomyoma of the myometrium ‘fibroid’
A benign neoplasm of smooth muscle
Localised
Slow growing
Consequences of benign neoplasms
Pressure on adjacent tissue
Obstruction of lumen of a hollow organ
Hormone production
Transformation into a malignant neoplasm
Symptoms for the patient
Clinical problems of benign neoplasms
Pressure on adjacent tissue
-bladder (frequency) Rectosigmoid (constipation)
Obstruction to lumen of a hollow organ
-adjacent (ureters) blocking endocervix
Hormone production
-? erythropoietin producing polycythaemia
Transformation into malignant neoplasm
-probably malignancy arises de novo
Abnormal uterine bleeding, pain
Malignant neoplasms
Invade into surrounding tissues
Spread via lymphatics to lymph nodes and blood vessels to other sites (metastasis)
Generally grow relatively quickly
Variable resemblance to parent tissue
How does malignant neoplastic tissue look different to normal tissue?
Loss of differentiation
Loss of cellular cohesion
Enlarged irregular dark nuclei
Increased numbers of mitoses
