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Pelvic Pathology > Lesson 5 (Part 2) > Flashcards

Lesson 5 (Part 2) Flashcards

1
Q

What are 3 differential diagnosis for polyps?

A
  1. Hyperplasia
  2. Endometrial cancer
    - bleeding –> symptomatic ***
  3. Submucosal fibroid
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2
Q

Stalk

A

Pedicle artery sign

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3
Q

SHG

A

Sonohysterogram

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4
Q

What does it mean if you see a pedicle artery sign on colour doppler for polyps?

A

You dont need a sonohysterogram if you can see it with regular US

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5
Q

PMB

A

Post menopausal bleeding

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6
Q

What is SHG good at?

A

Differentiating polyps and fibroids

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7
Q

What can you see with a SHG? (2)

A
  1. Polyp seen arising from the endometrial

2. Submucosal fibroid normal layer from the endometrial is seen overlying

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8
Q

What is a treatment for polyps?

A

Dilation and Curettage on woman with polyps

  • PMB
  • polyps can be missed with D/C so a hysteroscopy is recommended if still bleeding and the endometirum is >8mm
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9
Q

What is the most common gynecologic malignancy in North America?

A

Endometrial Carcinoma

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10
Q

Is endometrial carcinoma highly curable?

A

Yes

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11
Q

Were do you see most endometrial carcinoma located?

A

Confined to the uterus

- 75%

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12
Q

Who do you see most endometrial carcinoma with?

A

Postmenopausal women

- 75-80%

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13
Q

What is the most common clinical presentation of endometrial carcinoma?

A

Uterine bleeding

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14
Q

What percentage of women with PMB have endometrial carcinoma?

A

10%

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15
Q

What is the sonographic appearance of endometrial carcinoma? (4)

A
  1. Thickened endometrium
  2. Heterogeneous echotexture
  3. Irregular or poorly defined margins
  4. Can cause obstruction blocks the cervix
    - hydrometra or hematometra
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16
Q

Why can endometrial carcinoma be tricky? (2)

A
  1. Well defined and uniformly echogenic

2. Can have the same appearance as endometrial hyperplasia or polyps

17
Q

What is 3 differential diagnosis of a thicken endometrium for a women in her peri or post menopausal years?

A
  1. Hyperplasia
  2. Polyps
  3. Cancer
18
Q

What is needed to confirm the differential diagnosis of a thicken endometrium for a women in her peri or post menopausal years?

A

A biopsy

19
Q

What was the first thought with endometrial cancer when using colour and spectral doppler?

A

That low resistance flow in the uterine arteries distinguish normal postmenopausal endometriums from cancer
- found to not be significant

20
Q

What is the best way to measure postmenopausal endometriums from cancer?

A

Measure the endometrial thickness

21
Q

What is the role of sonographers in pre-op for endometrial cancer? (2)

A
  1. To determine if there is a myometrial invasion
  2. If there is an intact subendometrial Halo
    - superficial invasion
22
Q

What layer of the uterus is involved with the subendometrial halo?

A

The inner layer of the myometrium

23
Q

What is contrast enhanced MRI a superior method for in staging and pre-op? (3)

A
  1. Myometrial invasion
  2. Cervical extension
    - stage 2
  3. Extrauterine extension
    - stage 3 & 4
24
Q

What is an example of a rare uterine sarcoma?

A

Leiomyosarcomas

25
Q

What sarcomas arise from the endometrium? (4)

A
  1. Carinosarcomas
  2. Endometrial stromal sarcoma
  3. Adenosarcomas
  4. Undifferentiated sarcomas
26
Q

What does the endometrial stomal involve?

A

Myometrium

- diffuse or focal

27
Q

What can endometrial stromal be mistaken for?

A

Leiomyoma

28
Q

What occurs in the majority of women with PMB?

A

Endometrial atrophy

29
Q

How does Endometrial atrophy appear on US? (3)

A
  1. Usually thin
    - <5mm
  2. Homogeneous
  3. Can have cystic changes and be thick
    - therefore it can look like cystic hyperplasia

Pelvic Pathology (21 decks)

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