Pathology of the Female Genital Tract Flashcards
What are the different portal os entry for pathogens in the female genital tract?
- Ascending infection
- Haematogenous spread
- Descending from ovary
- Transneural infection
How does the innate immune system prevent infection in the female genital tract?
Sterile environment:
- physical barriers e.g. cervix
- neutrophils, macrophages, complement, cytokines
How does the adaptive immune system prevent infection of the female genital tract?
Response to pathogens by tolerate spermatozoa and foetus
- Humoral immunity e.g. local and systemic antibodies
- Cellular immunity e.g. T cells
How does oestrogen influence immunity?
Disease resistance is under the influence of oestrogen (upregulates T and B cells)
How does progesterone (P4) influence immunity?
Uterus more susceptible to infections during pregnancy
promotes poorer immunity due to presence of foetus when progesterone is high
What does inflammation of the uterus lead to in terms of hormone production?
Epithelial and mucosal surface loss, leading to decreased PGF2alpha production (no lyses of CL)
When is there better drainage of the cervix?
At oestrus because the cervix is open
Where and what disorders of the female genital tract occur?
Developmental abnormalities
Non-infectious disease
Infectious disease
Neoplasia
At what levels can sex be determined?
Genetic
Gonadal
Ductal
Phenotypic
What is the difference between a male pseudohermaphrodite and a true haemophrodite?
Male = testes replace ovaries True = gondal tissues of male and female
What are the types of developmental ovarian cysts?
Panovarian cysts Intraovarian cysts (Don't cause infertility unless large size reached)
What are the types of acquired ovarian cysts?
Follicular cysts
Anovulatory luteinised cysts (luteal)
Cystic corpora cutea
Describe follicular cysts….
Failure of mature follicle to ovulate >2.5cm (cow), >1cm (sow) Persistence for over 10 days Anovulation without lutinisation due to HPOA abnormality Lack of LH peak Stress = high cortisol which reduces GnRH levels Anoestrus Nymphomania
Describe anovulatory cysts (luteal cysts)
Anovulation with luteinisation of theca - Delayed or insufficient LH peak Thicker wall Mostly anoestrus Some progesterone production Interferes with regular cycling
Describe cystic corpora lutea…
Normal ovulation
Ovulation papilla on surface
No infertility
Confused with luteal cysts
What is oophoritis?
Inflammation of the ovary
Rare
Infectious causes: FIP, BVD
Ascending or systemic infection
What ovarian neoplasias are there?
Germ cell neoplasm
- Dysgerminoma
- Teratoma
Gonadal stroma neoplasm
- Granulosa cell tumour
- Tecoma
- Luteoma
Epithelial neoplasm
- Cystdenoma
- Cystadenocarcinoma
Secondary neoplasia
- Lymphoma
- Mammary carcinoma bitch
- Intestinal carincoma cow
What is dysgerminoma?
Primitive germ cell neoplasm
Smooths surface
Areas of haemorrhage or necrosis
Mostly benign and undifferentiated
What is a teratoma?
Totipotent germ cell tumour
Solid and cystic areas can include bone, hair, cartilage
Mixed tissues
Mostly benign and well differentiated
Non infectious disease of the oviduct?
Hydrosalpinx (distally blocked oviduct filled with serous or clear fluid)
- Congenital
- Acquired
Infectious diseases of the oviduct?
Pyosalpinx
Salpingitis (inflammation of wall)
Non-infectious diseases of the uterus?
Physical
- Torsion, rupture, prolapse
Endometrial growth disturbances
- Endometrial hyperplasia, mucometra, hydrometra, pseudopregnancy
What is cystic endometrial hyperplasia?
Thickened wall with nodular cysts in wall of dog uterus
Extended luteal phase (high P4) = sensitive to irritant leading to cystic distension of uterine glands
How are cystic endometrial hyperplasia and pyometra linked in the bitch?
CEH predisposes pyo because nodular environment provides ideal growth environment
High P4 = weakened immunity
What stage of oestrus do bitches with pyo usually present?
Few weeks after oestrus (3-6) due to luteal phase (high P4, low immunity)
Describe pyometra in the cow
Uterine disease (endometritis, metritis) predisposes to pyo
Early postpartum/afterbreeding
Persistent CL leads to high P4 levels
Functional cervical closure but usually some discharge
Rarely systemic signs
Treat by getting her cycling again (PGF2alpha and GnRH)
Describe pyometra in the mare…
Follows difficult parturitions with infections
Continue cycling during disease
Hormonal influences less important
Due to poor perineal conformation (less drainage)
No cervical closure = discharge
Rarely systemic disease
Inflammatory disease of the uterus?
Pyometra
Endometritis
Metritis
Describe endometritis…
Limited to uterine mucosa Post service or post partum Inflammatory infiltrate into mucosa Usually self-limiting if mild Can become chronic and fibrous, leads to problems with PGF2alpha production and get persistent CL
Describe metritis…
Inflammation of all layers of the uterine wall
More severe
Potentially life-threatening due to toxaemia
Describe leiomyoma
Neoplasia of uterine smooth muscle Bitch Benign Oestrogen involved Fibrous
Describe uterine neoplasia in the cow…
Carcinoma
- Mainly in cow
- EBL (enzootic bovine leukosis) suspected = notifiable
- Metastases to regional LNs, lungs and peritoneum
Lymphosarcoma
- EBL
- Heart, abomasum, LNs, uterus affected
Non inflammatory diseases of the vulva and vagina?
Anomalies
Tumefaction
- Swelling due to disease affecting oestrogen levels
Inflammatory diseases of the vulva and vagina?
Trauma
Herpesvirus
CEM (notifiable)
Dourine (notifiable)
Neoplasms affecting the vulva and vagina?
Leiomyoma
Transmissible venereal tumour
Fibropapilloma
SCC of vulva
