pathology ovary/uterus

Question 1

teratoma (dermoid cyst)

Answer 1

• all ages including children
• derived from postmitotic germ cells
• composed from a variety of mature tissues derived from endoderm, mesoderm, ectoderm
• usually benign, occasionally malignant

Question 2

mucinous cystadenoma

Answer 2

• benign
• cystic tumour lined by mucinous epithelium
• wide age range
• pain and mass lesion
• unilateral
• can be very large

Question 3

classification of ovarian epithelial tumours

Answer 3

• mucinous vs serous
  mucinous = mucinous epithelium
  serous = tubal type epithelium
• benign or borderline or malignant

Question 4

causes of infection of fallopian tubes

Answer 4

• usually bacterial
• TB
• parasites

Question 5

clinical presentation of infection of fallopian tubes

Answer 5

depends on organism and site

• abnormal bleeding
• vaginal discharge
• tender abdomen
• cysts
• infertility

Question 6

findings of ectopic pregnancy in fallopian tubes

Answer 6

• adnexal mass
• tenderness in abdomen
• blood test = beta HGC elevated
• ultrasound = empty uterus and adnexal mass

Question 7

leiomyoma

Answer 7

smooth muscle tumour of the myometrium

- fibroid nodules

Question 8

tumours of the muscular uterine wall

Answer 8

leiomyoma (fibroid)

• benign SM tumours
• common
• hormone receptive

leiomyosarcoma
- malignant tumour of SM

Question 9

define endometriosis

Answer 9

presence of endometrial tissue outside the uterus

Question 10

why is endometriosis a problem

Answer 10

• endometriosis responds to hormones during menstrual cycle
• bleeds into adjacent tissue during menstruation causing pain, cysts, tissue inflammation
• can give rise to malignancy

Question 11

“chocolate cyst”

Answer 11

benign

cystic lesion filled with clotted blood in ovaries

Question 12

investigations when heavy menstrual bleeding is present

Answer 12

• ultrasound to show thickness of endometrium
• pipelle biopsy
• curettage (gets biopsy with use of speculum)

Question 13

histology of endometrial carcinoma

Answer 13

glands proliferate and become increasingly crowded and complex

Question 14

causes of excess estrogen (leads to endometrial cancer)

Answer 14

• obesity
• PCOS
• hormone secreting tumour
• early menarche, late menopause
• exogenous estrogen

Question 15

consequences of too much estrogen

Answer 15

continuous proliferation of cells, hyperplasia. if it undergoes mutation can become neoplasia
overstimulation of endometrium

Question 16

types of pap smear

Answer 16

conventional smear (old technique)

cytobrush = liquid-based cytology (both HPV testing & cervical cancer)

Question 17

management of different cervical cancer grades

Answer 17

normal
= 3 year follow up

low grade squamous intraepithelial lesion (LSIL)
= next smear in 12months

high grade (CIN 3) 
  = referral to gynaecologist for treatment