Pathoma: Endometrium and Myometrium Flashcards

1
Q

Growth of the endometrium is driven by _______________.

A

estrogen

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2
Q

Shedding of the endometrium occurs by _____________.

A

loss of progesterone

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3
Q

What is D&C?

A

Dilation and curettage

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4
Q

Describe Asherman syndrome.

A

With loss of the regenerative basalis layer of the endometrium, such as by overaggressive D&C, women can develop secondary amenorrhea.

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5
Q

What presentation is typical of anovulatory cycle?

A

In an anovulatory cycle, the endometrium grows due to estrogen but does not shed because progesterone (normally made by the corpus luteum) never rises and thus never leads to shedding through loss. The next cycle, however, is likely to present with bleeding because the endometrium grows until it becomes hypoxic.

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6
Q

Acute endometritis is often caused by ____________.

A

placental remnants

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7
Q

What cells are characteristic of chronic endometritis?

A

Plasma cells (this is important because there are normally lymphocytes in the endometrium)

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8
Q

What drug can cause a hyperplastic protrusion of endometrium?

A

Tamoxifen

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9
Q

Endometriosis presents with ___________________ outside the endometrial lining of the uterus.

A

endometrial glands and stroma

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10
Q

What are some theories as to why endometriosis occurs?

A

Some think that during shedding some basalis tissue might get pushed up into the fallopian tubes (and in some cases out of the tubes) and seed there. Others think it’s a process of metaplasia. Lastly, some think basalis tissue spreads lymphatically, as there are some rarer cases of endometriosis in the lungs.

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11
Q

The most classic presentation of endometriosis is ____________.

A

in the ovary (a “chocolate cyst”)

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12
Q

What is adenomyosis?

A

Endometriosis of the myometrium

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13
Q

Endometriosis increases the risk of ________________.

A

carcinoma, especially in the ovary

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14
Q

What does estrogen do on a histologic level to the endometrium?

A

It leads to gland hyperplasia within the endometrium. This is evidenced by more glands related to stroma.

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15
Q

What can help predict whether endometrial hyperplasia will progress to carcinoma?

A

Nuclear atypia

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16
Q

Talk about the two pathways to endometrial carcinoma.

A
  • Hyperplasia can lead to carcinoma. This is called “endometrioid” cancer. More often in perimenopausal women.
  • Carcinoma can arise sporadically from an atrophic endometrium. This is called serous papillary. More often in elderly women. This is also caused by p53 mutations.
17
Q

Leiomyomas occur most often in ______________.

A

menopausal women

18
Q

What’s the best way to distinguish between leiomyoma and leiomyosarcoma?

A

The malignant version will have necrotic cores while the benign version looks like “white, whorled masses.”

Also, the malignant form more often occurs in older women.

19
Q

What symptoms does leiomyoma most often present with?

A

Nothing. It is usually asymptomatic.

20
Q

True or false: leiomyomas carry no increased risk for malignancy.

A

True. Leiomyosarcomas occur sporadically.