Pathology of the Uterus Flashcards
What are the phases of the Ovarian cycle?
Follicular phase
Ovulation
Luteal phase
What are the phases of the Uterine cycle?
Menstrual phase
Proliferative phase
Secretory phase
What is present in a Graafian follicle?
Oocyte
Granulosa cell
What are causes of abnormal uterine bleeding post menopause?
Atrophy Endometrial polyp Exogenous hormones, HRT, tamoxifen Endometritis Bleeding disorders Hyperplasia Endometrial carcinoma Sarcoma
How thick is the endometrium?
> 4mm post menopausal
16mm in premenopausal
What is used to assess the endometrium?
Hysteroscopy
How big is an endometrial pipelle?
3.1 diameter
What information is needed in the history?
Age Date of LMP and cycle length Patterns of bleeding Hormones Recent pregnancy
What is DUB?
Irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining
No organic cause for bleeding
What is the most common cause of DUB?
Anovulatory cycles
Does the corpus luteum form in DUB?
No
What happens to the functionalis layer?
Continues to grow
What is luteal phase deficiency?
Insufficient progesterone or poor response by the endometrium to progesterone. Abnormal follicular development (inadequate FSH/LH) - poor corpus luteum
What can happen in a disordered proliferation?
Even when LMP was 8 weeks prior, the glands and stroma continue to grow
What are organic causes of AUB?
Endometritis Polyp Miscarriage Adenomyosis Leiomyoma
What is endometritis?
Diagnosed by abnormal pattern of inflammatory cells
Cervical mucous plug protects the endometrium from ascending infection
Cyclical shedding of the endometrium also makes it relatively resistant
What organisms can cause endometritis?
Neisseria Chlamydia TB CMV Actinomyces HSV
Describe chronic plasmocytic endometritis?
Infectious until proven otherwise
Associated with PID (Neiserria, chlamydia, enteric organisms)
Describe endometrial polyps?
Usually asymptomatic but may present with bleeding/discharge
Often around/after menopause
Usually benign
Endometrial carcinoma can present as a polyp
What are the Myometrium causes of AUB?
Adenomyosis
Endometrial glands and storma within the myometrium
Leiomyoma - benign tumour of smooth muscle, may be found in locations other than the uterus
Describe Leiomyoma?
may be menorrhagia/infertility/mass effect, pain
Single or multiple, may be distort uterine cavity
Growth is oestrogen dependant
Microscopic - interlacing smooth muscle cells
How common is a Leiomyosarcoma?
rare
What is a molar pregnancy?
Abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus (or tube)
What is a gestational trophoblastic disease?
Grows as a mass characterised by swollen chorionic villi
Can be partial or complete moles
How do partial moles occur?
One egg fertilised by 2 sperm or by one sperm with 2 dna sets. making foetus triploid
What is a complete mole?
When the egg loses its DNA and the sperm becomes diploid meaning all the DNA of the foetus is from the father
