reproductive system pathologies

Question 1

enlargement of prostate gland

Answer 1

begin prostatic hyperplasia

Question 2

describe benign prostatic hyperplasia

Answer 2

Enlargement of the prostate gland
May be called benign prostatic hypertrophy but seems to be mainly more cells, not bigger
Common in men older than 60 yrs. of age
May cause the inability to empty bladder completely, leading to partial urinary tract obstruction, bilateral ureteral dilation and hydronephrosis
US, MRI, excretory urography/ voiding cystogram for diagnosis

Question 3

radiographic appearance of prostatic hyperplasia (benign)

Answer 3

On a voiding cystogram:
Elevated bladder floor - smooth
Fishhook distal ureters

Question 4

2nd most common malignancy in men

Answer 4

prostate cancer-Adenocarcinoma of the Prostate Gland

Question 5

what is a digital exam for Adenocarcinoma of the Prostate Gland

Answer 5

Finger in RECTUM, not Digital imaging

Question 6

Adenocarcinoma of the Prostate Gland

Answer 6

Prostate cancer is the 2nd most common malignancy in men
Almost all prostate cancers are adenocarcinoma
May cause bladder neck obstruction, infiltration of the trigone, or invasive obstruction of ureters = potential obstruction of upper urinary tract
Digital exam = finger in rectum not digital imaging!
US, MRI, excretory urography/ voiding cystogram for diagnosis

Question 7

radiographic + imaging appearance Prostate gland adenocarcinoma

Answer 7

Radiographic appearance
Irregular elevated base of bladder on voiding cystogram
Imaging appearance:
Transrectal (TR) US best technique to detect
MRI for staging and determining malignancy

Question 8

uterine fibroids

Answer 8

Leiomyomas
Benign smooth-muscle tumors that can vary in number and size
Growth of fibroid tumors stimulated by estrogen
May put pressure on other organs if large

Question 9

another term for uterine fibroids

Answer 9

leiomyomas

Question 10

radiographic appearance of uterine fibroids

Answer 10

Radiographic appearance:
KUB – characteristic mottled, mulberry, or popcorn calcification
Smooth lobulated nodules, stippled (numerous dots or specks) or whorled (spiral or swirly)
US/MRI also used

Question 11

what is the most common malignancy for women 44-50 years old

Answer 11

breast cancer

Question 12

most common type of breast cancer

Answer 12

adenocarcinoma

Question 13

describe breast cancer

Answer 13

Breast cancer is most common malignancy for 44-50-year-old women
Most often UOQ
There are many types of breast cancer
Adenocarcinoma is the most common type of breast cancer
Develops from glandular cells in epithelial tissue involving the ducts or lobules
May have lump, skin thickening, dimpling (peau d’orange), nipple retraction
Mainly a women’s disease, but men do get breast cancer

Question 14

radiographic appearance of breast cancer

Answer 14

Mammography – Mass and/or calcifications
Poorly defined mass with areas of distortion and has irregular margins with numerous fine linear strands or spicules radiating from it (spiculated/stellate)
Multiple small clustered (localized) calcifications or microcalcifications
Nipple retraction
Thickened skin

Question 15

breast cancer in situ

Answer 15

For breast cancer, in situ means that the cancer cells remain confined to ducts or lobules
Sometimes referred to as non-invasive breast cancer

Question 16

whats the gold standard for breast imaging

Answer 16

mammography -Full field digital mammography aided by AI systems (CAD) for tumor recognition
Now DBT used commonly
BI-RADS used

Almost all breast cancers appear as a mass and or clustered calcifications
Prompt biopsy is required when this is seen
Magnification images may also be taken

Question 17

breast biopsy

Answer 17

Fine Needle Aspiration (FNA)
Removes fluid sample for analysis
Uses mammography or US
Core Biopsy (with/without vacuum assistance)
Next slide
Surgical biopsy /open biopsy
Suspicious lump removed and analyzed

Question 18

Fibrocystic Breast Changes

Answer 18

Breast tissue thickens, cysts develop
Cyst = fluid filled sac, well circumscribed
Cysts vary in size, number and composition (and more fibrous tissue may be present in breast)
Cysts are usually bilateral in FBC
Cyst size changes with menstrual cycle
Potentially painful, lumpy breasts
Radiographic appearance (mammography):
Multiple cysts (roundish radiopaque masses)of varying sizes
Usually bilaterally in FBC

Question 19

fibroma of the breast

Answer 19

Most common benign breast tumor
Consists of fibrous (connective) and glandular tissue
Smooth, round or oval, gently lobulated
Solid lesion
Not pre-cancerous

Question 20

mammography appearance of the cyst

Answer 20

Mammographic appearance - cyst:
Mammography: Smooth, well-circumscribed circular mass
No speculation (no invasion into surrounding tissue)
It may have a halo surrounding
US needed to differentiate cystic vs. solid
US shows fluid/cystic mass

Question 21

Mammographic appearance - fibroadenoma:

Answer 21

Mammography: Smooth, well-circumscribed, often lobulated mass
No speculation (no invasion into surrounding tissue)
Popcorn calcification may be present
US to differentiate cystic vs. solid
The US shows a solid mass

Question 22

Female Infertility

Answer 22

Infertility: Not being able to get pregnant (lack of fertilization or implantation)
Due to abnormal uterus, obstructed fallopian tubes, issues with eggs
Evaluated in 2 ways in DI: US, hysterosalpingogram
Radiographic appearance:
Hysterosalpingogram (under fluoroscopy) – iodinated contrast to demonstrate ovaries, fallopian tubes and uterus and any blockage or malformation is seen
Can sometimes open blocked tubes
US- screening for congenital anomalies and to monitor treatment