[PATHO] REVISION 2 Flashcards
purulent inflammation 2ry to introduction of bacteria from uterine cavity to tubal lumen
acute salpingitis
MC causative agent of acute salpingitis
Neisseria gonorrhea
acute salpingitis gross picture
tube is swollen congested
lumen filled w/ pus
acute salpingitis microscopic picture
acute inflammatory process
polymorphs & pus cells
chronic non specific salpingitis gross picture (4)
1-tube is irregular, distended
2-fibrous adhesion over serosal surface
3-permanent bridging b/w plicae
4-wall infiltrated by lymphocytes + plasma cells
salpingitis complications (5)
1-extension–> pelvic peritonitis
2-extension–>tubo-ovarian abscess
3-chronicity—> hydrosalpinx/ pyosalpinx
4-if bilateral–>sterility
5-ectopic pregnancy
if chronicity of salpingitis is mild this leads to
hydrosalpinx
if chronicity of salpingitis is severe this leads to
pyosalpinx
TB salpingitis gross picture (3)
1-serosal tubercles
2-tube is elongated, nodular, irregularly distended
3-adhesions to nearby organs
TB salpingitis microscopic picture
caseating granuloma
tubal pregnancy gross picture
tube distended by hemorrhagic clot enmeshing chorionic villi
tubal pregnancy fate
1-abortion
2-rupture & intraperitoneal bleeding
tubal pregnancy pathogenesis
1-factors ↑ tubal receptibility (endometriosis)
2-factors blocking zygote passage to uterine cavity (chronic salpingitis/ congenital tubal diverticulae)
purulent inflammatory process following introduction of neisseria gonorrhea from uterine cavity to tubal lumen
acute salpingitis
obliteration of fimbriated end w/ dilatation of tube
wall is whitish, thin, translucent
tube contains clear serous fluid
hydrosalpinx
uterus is enlarged
mass of grapelike structures of translucent white cysts
no fetal parts
weighs > 200g
hydropic swelling of chorionic villi
chorionic villi filled w/ avascular loose myxoid stroma
hyperplastic sheets of cytotrophoblasts & syncytiotrophoblasts
cytologic atypia is present
complete hydatidiform mole
obliteration of fimbriated end w/ dilatation of tube
wall is thick & opaque
lumen distended w/ pus
pyosalpinx
tubes are swollen & congested
lumen is filled w/ pus
tubes show polymorphs & pus cells
acute salpingitis
tube is distended, irregular
fibrous adhesions on serosal surface
healing & organization
permanent bridging b/w plicae
lymphocytes & plasma cells
chronic salpingitis
blood borne organism lodged in tubes
tube is elongated, nodular, irregularly distended
adhesions to nearby organs
serosal tubercles
caseating granuloma
TB salpingitis
MC routes of lymphatic spread in TB salpingitis
intestinal
bladder
tube is distended w/ hemorrhagic clot enmeshing chorionic villi
tubal pregnancy
uterus may be enlarged
few vesicles
few fetal parts seen
villous edema of some villi
trophoblastic proliferation is focal & slight
partial hydatidiform mole
gross picture of complete hydatidiform mole (4)
1-usually uterus is enlarged
2-grape-like structures of thin translucent cysts
3-NO fetal parts
4-weighs> 200g
complete hydatifirom mole microscopic picture (4)
1-hydropic swellings of chorionic villi
2-chorionic villi filled w/ avascular loose myxoid stroma
3-hyperplastic sheets of cyto & syncytiotrophoblasts
4-cytologic atypia
complete hydatiform complications
choriocarcinoma
invasive mole
invasive mole micro picture
chorionic villi show active proliferation of both cyto & syncytiotrophoblasts
grape like clusters in uterine cavity
complete hydatidiform mole
hyperplastic sheets of cyto & synctiotrophoblasts
complete hydatidform mole
uterine bleeding
possible rupture of uterus
abortion
↑ hCG
complete mole
penetrates myometrium & can perforate uterine wall
villi show active proliferation to cyto & syncytiotrophoblasts
invasive mole
large hemorrhagic necrotic mass destroying uterine wall
invades uterine wall, BV, lymphatics
no stroma
no BV
no chorionic villi formed
extravasated blood & necrosis
contains cytotrophoblasts & synyctial cells
invades
choriocarcinoma
choriocarcinoma spread
lungs
liver
vulva
vagina
polymorphs & pus cells seen in
acute salpingitis
lymphocytes & plasma cells seen in
chronic salpingitis
cytotrophoblasts & syncytiotrophoblasts seen in
1-complete mole
2-partial mole
3-invasive mole
cytotrophoblasts & syncytial cells seen in
choriocarcinoma
cannon ball appearance seen in
choriocarcinoma spread to lungs
coffee bean nucleus seen in
cuboidal cells of granulosa cell tumor
tuboovarian abscess gross picture (2)
fibrotic wall
cavity containing purulent material
wall of ovary is fibrotic
cavity filled w/ purulent material
necrosis
granulation tissue
inflammatory cell infiltration
fallopian tube bound to ovary in distorted mass
tubo-ovarian abscess
tubo-ovarian abscess micro picture (3)
necrosis
granulation tissue
inflam cell infiltration
chronic granulomatous oophritis caused by
TB
Bilharziasis
MC cause of enlarged ovaries
cysts
palpable ovarian mass
pelvic pain
menstrual abnormalities
↑estrogen
unilocular cyst 1-5cm
outer surface is smooth
thin wall
cyst contains clear serous fluid
cyst lined by granulosa cells surrounded by theca internal cells
follicular cysts
follicular cyst gross picture (7)
1-unilocular
2-1-5 cm
3-unilateral/ bilateral
4-single/multiple
5-smooth outer surface
6-thin wall
7-filled w/ clear serous fluid
follicular cyst micro picture
lined by granulosa cells surrounded by theca interna cells
follicular cysts originate from
unruptured graafian follicle
or
follicle which had ruptured & immediately sealed
corupus luteum cyst orignates from
delayed resolution of corpus luteum
corpus luteum gross picture (2)
1-unilocular 3-6 cm
2-yellow festooned lining
corpus luteum cyst micro picture
lined by luteinizing granulosa cells
that may be hemorrhagic
estrogen secreting cyst
follicular cyst
progesterone secreting cyst
corpus luteum