Pathology of the Uterine Body and Endometrium Flashcards

1
Q

What is the term for the existence of endometrial tissue within the myometrium?

A

Adenoymosis

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2
Q

Give examples of common sites of endometriosis

A
Ovaries
Peritoneal surfaces (uterine ligaments, rectovaginal septum)
Large and small bowel
Appendix
Vagina
Mucosa of cervix
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3
Q

Describe the metastatic theory of the pathophysiology of endometriosis

A

Retrograde mentsruation or surgical produces introduce endometrium to sites outwith the uterine cavity

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4
Q

Describe the metaplastic theory of the pathophysiology of endometriosis

A

Endometrium arises directly from the coelomic epithelium of the pelvis as this is where endometrium originates from during embryological development

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5
Q

What is endometriosis?

A

The presence of endometrial tissue outside of the uterus

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6
Q

What are the clinical symptoms of endometriosis?

A

Dysmenorrhoea, pelvic pain and infertility

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7
Q

Endometrial polyps can be associated with which anti-cancer drug?

A

Tamoxifen

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8
Q

What are endometrial polyps?

A

Exophytic masses of variable size which project into the endometrial cavity

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9
Q

How are endometrial polyps treated?

A

Hysteroscopy

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10
Q

Describe the microscopic appearance of endometrial polyps

A

Haphazardly arranged glands with preservation of a low gland to stroma ratio
Thick walled blood vessels and fibrous stroma
Glands are usually inactive but can show ploiferation, secretory changes or metaplasia

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11
Q

It is possible for frank adenocarcinoma to be found in endometrial polyps. T/F?

A

True

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12
Q

Endometrial hyperplasia and adenocarcinoma are associated with prolonged oestrogen stimulation. Give examples of causes of this

A

Anovulatory cycles
Endogenous sources of oestrogen (obesity, PCOS, oestrogen secreting ovarian tumours)
Exogenous sources of oestrogen (oestrogen only HRT)

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13
Q

What are the histological characteristics of endometrial hyperplasia?

A

Increase in gland to stroma ratio

With or without cytological atypia

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14
Q

Atypical endometrial hyperplasia is a precursor of endometriosis adenocarcinoma. T/F?

A

True

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15
Q

How can endometrial hyperplasia be managed?

A

Progesterone therapy such as Mirena, IUS or hysterectomy

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16
Q

How is endometrial adenocarcinoma treated?

A

Hysterectomy possibly with further oncological treatment

17
Q

What is the name for a benign smooth muscle tumour fo the myometrium?

18
Q

In women of what age are leiomyomas most commonly found?

A

Reproductive age

19
Q

Smaller leiomyomas are often asymptomatic. If leiomyomas of the myometrium are large, what symptoms can this produce?

A

Abnormal bleeding
Urinary frequency
Impaired fertility

20
Q

Describe the appearance of leiomyomas.

A

Sharply demarcated round grey-white tumours with a whorled cut surface
Microscopically they resemble normal smooth muscle

21
Q

What is the possible medical management of leiomyomas?

A

Progesterone secreting IUS, hormonal therapies, tranexamic acid and GnRH agonists

22
Q

What is the possible surgical management of leiomyomas?

A

Uterine artery embolisation
Myomectomy
Hysterectomy

23
Q

What is the name for malignant smooth muscle tumours of the myometrium?

A

Leimyosarcoma

24
Q

In women of what age are leiomyosarcomas most commonly found?

A

Between age 40 and 60

25
Describe the macroscopic appearance of leiomyosarcomas of the myometrium
Necrosis, haemorrhage, variable cut surface
26
Describe the microscopic appearance of leiomyosarcomas of the myometrium
Overt cytological atypia Necrosis Mitotic activity Infiltrative margins
27
Where do leiomyosarcomas fo the myometrium commonly spread to?
Lungs, liver, brain
28
Leiomyosarcomasof the myometrium initially have no symptoms. Laters, what symptoms can these tumours produce?
Bleeding and pain
29
Endometrial stromal sarcomas are usually low grade tumours. T/F?
True
30
How would you describe the macroscopic growth pattern fo an endometrial stromal sarcoma?
Worm like
31
If products of conception are to to the pathology laboratory to confirm an intrauterine pregnancy. What structures would a pathologist look for?
Chorionic villi | Implantation site
32
Gestational trophoblastic disease is an umbrella term for conditions such as...?
hydatidiform moles and frankly malignant tumours including chorionocarinoma
33
Hydatidiform moles are present with spontaneous miscarriage. T/F?
True
34
What is the cause of a partial hydatidiform mole?
Fertilisation of one egg by two sperm which results in a triploid karyotype
35
What is the cause of a complete hydatidiform mole?
Fertilisation of an egg with no genetic material, usually by one sperm which duplicates its chromosomal material or by two sperm
36
Microscopically, what features would you seen on a partial hydatidiform mole?
Oedematous villi | Subtle trophoblast proliferation
37
Microscopically, what features would you seen on a complete hydatidiform mole?
Markedly enlarged oedematous villi with central cisterns and circumferential trophoblast proliferation
38
Hydatidiform moles can become invasive. What complication can result form this?
Uterus rupture
39
What type of cancer can result from a complete hydatidiform mole?
Choriocarcinoma