Reproductive System Flashcards
What are the 3 pathologies of the male reproductive system?
Benign Prostatic Hyperplasia (BPH)
Carcinoma of the Prostate Gland
Testicular Tumours
What pathology is this describing?
Causes bilateral hydroureter (J shaped ureter), hydronephrosis, and cystitis
Benign Prostatic Hyperplasia (BPH)
What modalities are used to image Benign Prostatic Hyperplasia (BPH)?
CT or US
What sign is seen with Benign Prostatic Hyperplasia (BPH) in ultrasound?
US: Efiel tower sign
What is done to diagnose Benign Prostatic Hyperplasia (BPH)?
Transrectal biopsy using ultrasound
What is Benign Prostatic Hyperplasia (BPH) caused by?
Caused by hormonal changes
What population is Carcinoma of the Prostate Gland most common in?
Most common in men 50+
What three tests are done to diagnose Carcinoma of the Prostate Gland?
-Rectal test
-PSA blood test
-Biopsy to say for sure
What does a rectal test show with Carcinoma of the Prostate Gland?
-Hard, nodular, irregular mass (rectal test)
What does a PSA test show with Carcinoma of the Prostate Gland?
-PSA test (blood test)-Not specific, just indicates that something is wrong
T/F
Carcinoma of the Prostate Gland may be slow growing or very aggressive (takes time to develop or fast)
True
Where does Carcinoma of the Prostate Gland metastasize to?
Metastasizes to:
-Rectum, bladder
-Bone (osteoblastic)
What is the most common cancers for males?
Carcinoma of the Prostate Gland
How does Carcinoma of the Prostate Gland appear radiographically?
-Irregular impression of bladder floor
-May produce obstruction of upper urinary tract because it is putting pressure on the bladder
-Ivory vertebra
-Osteoblastic lesions
T/F
Carcinoma of the Prostate Gland causes an Increased risk of bladder infection
True
What Bones does Carcinoma of the Prostate Gland spread to and how is it spread?
-Pelvis, femurs, ribs, thoracolumbar spine
-(hematogenous spread)
What age is Testicular Tumours most commonly seen in?
-Typically occurs in younger men (20-35)
T/F
Testicular Tumours are almost always benign.
False;Almost always malignant
T/F
Testicular Tumours often presents as a painless lump
True
What are the two types of Testicular Tumours?
Seminoma or nonseminoma (50/50)
What are the 3 Treatments for Testicular Tumours?
-Orchiectomy
-Radiation
-Chemotherapy
What is the best modality to image Testicular Tumours?
Ultrasound is best imaging modality
How do testes appear normally in ultrasound?
Normal = homogenous medium-level echogenicity
How do Seminoma Testicular Tumours appear in ultrasound?
Seminoma – uniform hypoechoic w/o calcification
How do Teratoma Testicular Tumours appear in ultrasound?
inhomogenous, cystic and solid areas of calcification/cartilage
How do Seminomas Testicular Tumours appear in MRI?
homogenous and enhance w/ contrast
How do non Seminomas Testicular Tumours appear in MRI?
Non-seminomas – more heterogenous
When is MRI done to image testicular Tumours?
Done when ultrasound cannot differentiate
What are the pathologies of the female reproductive system?
Pelvic Inflammatory Disease
Cysts and Tumours
Uterine Fibroids
Breast Lesions
Ectopic Pregnancy
What is Pelvic Inflammatory Disease?
Inflammation of uterus, fallopian tubes, ovaries
What is the Peak incidence of Pelvic Inflammatory Disease?
between 20-24
What are the Common causes of Pelvic Inflammatory Disease?
-Venereal disease (STI)
-Multiple sexual partners
-Unsterile abortion or delivery
-Complication of IUD
What are the Pelvic Inflammatory Disease Complications?
-Infection (pus) may spill into peritoneum
-Pelvic abscess
-Peritonitis (inflammation of peritoneum)
What can Scarring and adhesions within fallopian tubes from Pelvic Inflammatory Disease cause?
May cause obstruction, infertility and ectopic pregnancy (implants into the walls of the fallopian tube)
What is a Pyosalpinx
large collection of pus in the fallopian tube seen with Pelvic Inflammatory Disease
What is the modality of choice for Pelvic Inflammatory Disease
US is the imaging procedure of choice for detecting PID and pelvic abscesses
What are Ovarian Cysts?
-Typically enlarged, unruptured follicles
What syndrome is seen with ovarian cysts?
-Polycystic Ovarian Syndrome
What modailites are used for cysts and tumours?
US and MRI
What is the primary tumour seen with the female reproductive system?
Primary cystadenocarcinoma
How does Primary cystadenocarcinoma appear radiographically?
-Psammomatous calcifications
-Large cystic mass with septations
What is a Germ Cell Tumour?
-A Dermoid Cyst which Contains teeth, hair, skin, fatty elements
Is a germ cell tumour of clinical concern?
No clinical concern unless it compresses something
What are Uterine Fibroids? What is another name for it?
-Very common, benign, smooth-muscle tumour
-Also called Leiomyoma
What is the growth of Uterine Fibroids stimulated by?
Growth stimulated by estrogen (Start growing during puberty and decrease after menopause)
T/F
Uterine Fibroids often multiple and vary greatly in size (not just between the different masses, but also over time)
True
What are the symptoms of Uterine Fibroids?
May be asymptomatic or may cause excessive menstrual bleeding/abnormal bleeding between periods
How do Uterine Fibroids appear radiographically?
Smooth or lobulated nodule w/ stipple or whorled appearance
Lesions can calcify (popcorn)
What are the types of Breast Lesions?
Benign and malignant lesions
What are the two types of Benign Breast Lesions?
-Fibrocystic Disease
-Fibroadenoma
What are the two types of Malignant breast lesions
-Adenocarcinoma
-Carcinoma in situ
Where are malignant breast lesions usually located?
-Most often upper lateral quadrant
T/F
Most malignant breast lesions are infiltrating duct carcinomas
True
What modalities are used to image Breast Lesions?
Mammography, US, and MRI
What is the modailty of choice for imaging Breast Lesions
US
What percentage of women are affected by Fibrocystic Disease
50%
How does the breast tissue feel with Fibrocystic Disease?
-Tissue feels lumpy or rope-like
-Especially in upper, outer areas of breast
What is the key sign that indicates that a lesion is benign?
If it is mobile
TF
With Fibrocystic Disease, Lumps fluctuate is size depending on menstrual cycle
True
TF
Fibrocystic Disease is unilateral.
False; Typically affects both breasts
How does Fibroadenoma appear radiographically?
-Smooth, well-circumscribed mass with no invasion of surrounding tissue. Solid mass with no cysts.
TF
Typically Fibroadenoma is unilateral and mobile
True
What is the most common cause of new cancers among women in Canada
Malignant Breast Lesions
TF
Malignant breast lesions usually arises from more glandular tissue
True
Where does breast cancer- Adenocarcinoma most often occur?
In upper, outer quadrant
What are the Risk Factors for Breast cancer-Adenocarcinoma?
-Family history of breast or ovarian cancer
-BRCA 1, BRCA 2 gene mutation
-Radiation exposure/therapy to the chest, neck, axilla region
-Nulliparous or first child after 30
-Early onset menstruation
-Late menopause
What are the 5 symptoms of Breast Cancer (Adenocarcinoma)
- Painless lump, rope-like area within breast tissue or axillary region
- Changes in the size or shape of the breast (distorted contour)
- Changes to the skin: dimpling, puckering, redness or flaking
- Changes to the nipple: redness, crusting or sudden nipple inversion
- Discharge from the nipple
What are the 5 radigoraphic signs of Breast Cancer (Adenocarcinoma)
- Poorly defined edges with areas of distortion
- Numerous fine linear strands or spicules radiating out from the mass
- Irregular margins
- Fixed, not mobile
- Cluster calcifications
What is the purpose of BI-RADS?
-Assigns a number based off of how suspicious something looks
What does BI-RADS stand for?
Breast Imaging-Reporting and Data System
How many levels of BI-RADS are there
6
What does a level of BI-RADS 0 indicate?
Incomplete (further imaging required)
What does a level of BI-RADS 1indicate?
Negative (not finding anything)
What does a level of BI-RADS 2 indicate?
Benign findings (Fibroadenoma etc.)
What does a level of BI-RADS 3 indicate?
Probably benign (suggest a follow-up in a short period of time)
What does a level of BI-RADS 4 indicate?
Suspicious abnormality (should consider a biopsy)
What does a level of BI-RADS 5 indicate?
Highly suggestive of malignancy (do a biopsy)
What does a level of BI-RADS 6 indicate?
Known biopsy-proven malignancy
Where does Carcinoma in situ originate?
-Carcinoma originates in the ducts or lobules of the breast
-Contained within these milk ducts
What is Carcinoma in situ?
A “pre-cancerous” = non-invasive, still a malignancy
TF
Carcinoma in situ is Typically asymptomatic, but found on screening mammograms
True
TF
Carcinoma in situ does not require treatment
False; Carcinoma in situ still requires treatment
What are the treatments for malignant breast lesions?
- Lumpectomy +/- Radiation Therapy/Chemotherapy +/- Hormone Therapy
- Mastectomy
What is an Ectopic Pregnancy
-Embryo attached outside the uterus
Where do Ectopic Pregnancy usually occur?
->95% Fallopian tube (tubal pregnancy)
-Cervix, ovaries, or within abdominal cavity
What are the Risk factors for an Ectopic Pregnancy
-Pelvic Inflammatory Disease
-In vitro fertilization (IVF)
What is the modality of choice for Ectopic Pregnancy?
US is modality of choice
How does an Ectopic Pregnancy appear in US?
-Enlarged uterus w/o gestational sac (body is preparing)
-Adnexal mass; next to the uterus
What are the Causes of Infertility?
1.Abnormal anatomy of uterus (uterine fibroids)
2.Ovaries unable to produce mature ova
3.Obstructed fallopian tubes
How do you confirm Infertility?
Hysterosalpingogram (salp)
(Confirms patency of the fallopian tubes)
What is seen with a Hysterosalpingogram when the person is infertile?
-Demonstrates fibroids, retroversion or other abnormalities with uterus
