Pathology Flashcards
indications for endometrial biopsy
abnormal uterine bleeding investigating infertility spontaneous/therapeutic abortion response to hormone therapy endometrial ablation work op prior to hysterectomy incidental finding of thicker endometrium on scan endometrial cancer screening in high risk pt
cause of AUB in pre-menopause
pregnancy/miscarriage DUB endometrial or endocervical polyp endometritis leiomyoma adenomyosis exogenous hormone defects bleeding disorders cervical/endometrial neoplasia hyperplasia
cause of AUB in post menopause
atrophy polyp hormone therapy - tamoxifen/HRT endometritis bleeding disorders hyperplasia endometrial cancer sarcoma
assessment of endometrium
biopsy
transvaginal USS
hysteroscopy
what transvaginal USS findings are an indication for biopsy?
thickness >4mm postmenopause
thickness >16mm in premenopause
forms of sampling for endometial biopsy and which is more thorough
endometrial pipelle
dilatation and curettage - more thorough
what is DUB
disordered uterine bleed, representing disruption in normal cyclic pattern of bleed and ovulatory hormone stimulation to endometrial lining
causes of DUB
most are anovulatory cycles PCOS hypothalamic dysfunction thyroid disorders hyperprolactinaemia luteal phase deficiency
organisms contributing to endometritis
neisseria chlamydia TB CMV Actinomyces HSV
inflammatory products leading to endometritis
IUD/IUS postpartum postabortal postcurettage chronic endometritis NOS granulomatous leiomyoma/polyp
how do endometrial polyps present, what age and are they cancerous
usually asymptomatic but may have bleed/discharge
menopause generally
almost always benign but can have carcinoma
what is adenomyosis and how does it present
endometrial glands and stroma within the myometrium
menorrhagia/dysmenorrhoea
what is a leiomyoma, what may it present as and what does its growth depend on
benign smooth muscle tumour and can be found in uterus or other places
menorrhagia, infertility, mass effect, pain
oestrogen dependent - often reproductive
what is a molar pregnancy
abnormal pregnancy where non-viable egg implants
swollen chorionic villi
what is a complete mole
single or 2 sperm combining woth egg that has lost DNA so sperm reduplicates to form 46 chromosomes and only paternal DNA seen
