[PATHO] DISEASES OF BODY OF UTERUS Flashcards
most common genital tract infection following delivery/abortion
acute endometritis (puerperal sepsis
puerperal sepsis
acute endometritis
acute endometritis gross picture
uterus: enlarged, soft, lined by purulent exudate
acute endometritis microscopic picture
endometrium: edematous, neutrophils, pus cells
later: endometrium becomes necrotic + myometritis
clinical picture of acute endometritis
abdominal pain
fever
purulent vaginal discharge
inflammation
abdominal pain
fever
purulent vaginal discharge
following abortion/delivery
uterus is enlarged, soft, edematous, lined by purulent exudate, neutrophils, pus cells
acute endometritis
follows abortion
assoc w/ retention of products of conception
postabortive endometritis
post-menopausal endometrial atrophy
postmenopausal bleeding
infiltration by lymphocytes & plasma cells
senile endometritis
types of chronic non specific endometritis
post-abortive
senile
most important diagnostic feautre of chronic NON SPECIFIC endometritis
plasma cells
TB endometritis occurs 2ry to
TB salpingitis
TB endometritis leads to
sterility
in TB endometritis endometrium is infiltrated by
multiple tubercles
in senile endometritis,
the endometrium is infiltrated by
lymphocytes
plasma cells
actinomyces israeli is common with
IUD
clinical feautres of endometritis
abdominal pain
fever
menstrual abnormalities
infertility & ectopic pregnancies can occur in chronic endometritis due to
damage & scarring of fallopian tubes
pyometria occurs due to
1-obstruction + infection
2-carcinoma
3-benign cervical stricture from senile atresia
4-after surgery
5-after cauterization
endometriosis definition
presence of endometrial tissue (stroma & glands) outside uterus
regurgitation theory of endometriosis
menstrual backflow through fallopian tube & subsequent implantation
metaplastic theory of endometriosis
endometrial differentiation from coelomic epithelium
extrapelvic endometriosis is explained by which theory
vascular/lymphatic dissemination theory
extrauterine stem/progenitor cell theory of endometriosis
circulating stem/progenitor cells from bone marrow differentiate into endometrial tissue
endometriotic tissue exhibits
1-↑inflammatory mediators (PGE2)
2-inflammation due to MQ recruitment + activation by stromal cells
3-stromal cells make aromatase–>estrogen production
4-
endometriotic tissue survival is enhanced by
inflammatory mediators
estrogen production
inflammation by MQ activation
endometriosis can be treated by
COX-2 inhibitors
Aromatase inhibitors
pelvic endometriosis sites (7)
1-ovaries
2-cervix
3-tubes
4-uterine ligaments
5-vagina
6-rectovaginal wall
7-pelvic peritoneum
A.chocolate cysts are seen in?
B. reason for their formation?
A.ovarian endometriosis
B.periodic bleeding at site of ovarian endometriosis
extrapelvic endometriosis sites (4)
1-laparotomy scars
2-vulva
3-umbilicus
4-appendix
Cl/P of endometriosis (3)
1-severe dysmenorrhea
2-pelvic pain
3-possible infertility
pelvic pain in endometriosis is due to
intrapelvic bleeding & intrabdominal adhesions
adenomyosis definition
growth of basal layer of endometrium down into myometrium
microscopic picture of adenomyosis
nests of stroma +/- glands in myometrium
what causes uterine wall thickening in adenomyosis
endometrial tissue triggers reactive hypertrophy of myometrium
adenomyosis effects (3)
-uterine enlargement & thickening
-dysmenorrhea
-pelvic pain
aetiology of endometrial hyperplasia
excess estrogen relative to progestin—>excessive endometrial proliferation
causes of excess estrogen in endometrial hyperplasia (4)
1-failure of ovulation w/ persistence of graafian follicle
2-prolonged estrogenic steroids use
3-estrogen producing lesions
4-obesity
estrogen producing lesions
polycystic ovary
granulosa-theca cell tumors
why does obesity lead to ↑estrogen
adipose tissue converts steroid precursors—>estrogen
gross picture of endometrial hyperplasia
uterus: moderately enlarged
endometrium:thickened, abundant, polyploid
types of endometrial hyperplasia
hyperplasia without atypia
hyperplasia with atypia
glands in hyperplasia w/o atypia are lined by
columnar epithelium w/ ↑mitosis
glands in hyperplasia w/atypia are lined by
atypical cells
endometrial intraepithelial neoplasm
(endometrial) hyperplasia with atypia
which type of endomertrial hyperplasia is associated w/ progression to cancer
hyperplasia w/ atypia