patho - endometriosis

Question 1

what is endometriosis

Answer 1

the presence of endometrial glands AND STROMA outside of the uterus

note: if only ‘presence of endometrial glands outside the uterus’ -> indicative of metastatic adenocarcinoma!

Question 2

what are some common organs affected by endometriosis?

Answer 2

fallopian tubes
surface of ovaries
uterine ligaments
pouch of Douglas
umbilicus
intestines - ileum, colon, appendix, rectum
perineum
abdominal wall

Question 3

what are some theories of the pathogenesis of endometriosis?

Answer 3

• regurgitation/ retrograde menstruation flow -> implanting of endometrial tissue at ectopic sites
• stem cell origin -> differentiate into endometrial glandular and stromal tissue cells
• benign metastases theory -> spread of endometrial tissue to distant sites
• metaplastic theory -> due to shared origin of endometrial tissue and coelomic epithelium

Question 4

what are some signs and symptoms of endometriosis?

Answer 4

dysmenorrhoea (painful menses)
infertility
pelvic pain
intestinal symptoms - due to involvement of bowel wall

Question 5

what are some possible complications of endometriosis?

Answer 5

• infertility
• scarring of affected organs
• may be a precursor to carcinoma (especially: endometriod carcinoma, and clear cell ovarian carcinoma, both of which are malignancies originating from surface epithelial cells)

Question 6

what are some examples of ovarian epithelial malignancies?

Answer 6

serous tumours
mucinous tumours
endometriod tumour
clear cell tumour
brenner cell tumour
cystadenofibroma

Question 7

what are some examples of ovarian germ cell malignancies?

Answer 7

teratoma
yolk sac tumours
choriocarcinoma
dysgeminoma
seminoma

Question 8

what are some examples of ovarian sex cord stroma malignancies?

Answer 8

fibroma
granulosa-theca cell tumour
sertoli-leydig cell tumour