Pathology of Uterus Flashcards
List stages of the ovarian cycle
Follicular phase
Ovulation
Luteal phase
List stages of the uterine cycle
Menstrual phase
Proliferative phase
Secretory phase
List pathological features of the uterus in the proliferative phase. Which harmone is involved in this process?
Tubular glands with columnar cells and surrounding dense stroma are proliferating to build up the endometrium following shedding with previous menstruation
Oestrogen
List pathological features of the uterus in the secretory phase. Which harmone is involved in this process?
Large torturous glands with luminal secretions
Prgoesterone
List indications for endometrial biopsy
Abnormal uterine bleeding Investigation for infertility Spontaneous and therapeutic abortion Endometrical cancer screening Response to harmonal therapy Endometrial ablation Prior to hysterectomy Thickened endometrium on scan
What is dysfunctional uterine bleeding?
Abnormal uterine bleeding that reflects disruption in normal cyclic pattern of ovulatory harmonal stimulation to the uterine lining with no organic cause
What is post-menopausal bleeding?
Abnormal uterine bleeding > 1 year after cessation of menstruation
List causes of abnormal uterine bleeding in adolescence and early reproductive life
DUB
Pregnancy/ miscarriage
Endometritis
Bleeding disorders
What is the commonest cause of DUB? How does this appear pathologically?
Anovulatory cycles
End of reproductive life and corpus luteum doesn’t form causinginsufficient progesterone and continued growth of functionalis layer
Disordered proliferation - glands and stroma continue to grow
List ADDITIONAL causes of abnormal uterine bleeding pre-menopause and reproductive life
Endometrial/endocervical polyp Leiomyoma Adenomyosis Hyperplasia Exogenous harmone effects (DUB Pregnancy/ miscarriage Endometritis Bleeding disorders)
List causes of abnormal uterine bleeding post-menopause
Atrophy Endometrial polyp Exogenous harmones (HRT, tamoxifen) Endometritis Bleeding disorders Hyperplasia/ endometrial carcinoma/sarcoma
List the three main methods of assessing the endometrium
Endometrial biopsy
TVUS
Hysteroscopy
An endometrial thickness of >__mm in postmenopausal women (__mm in premenopausal) is the indication for endometrial biopsy
4
16
State the main methods for sampling the endometrium
Endometrial pipette
Dilatation + curettage
Give examples of conditions causing anovulatory cycles and DUB
PCOS
Hypothalamic dysfunction
Thyroid disorders
Hyperprolactinaemia