Uterine and Ovarian Pathology Flashcards
1
Q
hematometra
A
- imperforated hymen
- cervical stenosis
- vagina neoplasm
- pelvic pain, amenorrhea, hypomenorrhea, pelvic mass
- large hypoechoic midline uterine mass, posterior enhancement
- differential: submucosal leiomyoma, endometrioma, retained products of conception
2
Q
leiomyosarcoma
A
- derived from smooth muscle of the uterus
- rare
- asymptomatic, vaginal bleeding
- heterogeneous uterine mass
- irregular margins
- differential: leiomyoma or endometrial carcinoma
3
Q
granulosa cell tumor
(ovarian)
A
- hormonal tumor
- increase in estrogen
- palpable mass
- irregular bleeding
- solid, homogeneous adnexal mass, may appear complex, endo thickening
- differential: pedunculated fibroid
4
Q
dysgerminoma
A
- malignant germ cell neoplasm
- most common ovarian malignancy in childhood
- asymptomatic, precocious puberty, pelvic pain, pelvic mass, associated with AFP and hCG levels, spread to lymphatics
- predominantly solid, homogeneous
- differential: cystadenocarcinoma or metastatic lesion
5
Q
asherman syndrome
A
- adhesions from a previous deep curettage or endo infection
- asymptomatic
- amenorrhea
- dysmenorrhea
- hypomenorrhea
- inferility
- endocavity difficult to distinguish
- bright echoes within the endocavity
- differential: normal proliferative phase or uterine mass compressing endo
6
Q
carcinoma
(pathology of the cervix)
A
- epithelial neoplasm
- third most common gynecological malignancy in the US
- asymptomatic, vaginal discharge or bleeding, palpable mass, weight loss, bleeding
- irregular margins, endo fluid, heterogeneous
- differential: leiomyoma, complex cervical cyst, ovarian mass
7
Q
brenner tumor
(ovarian)
A
- benign tumor arising from fibroepthelial tissue
- estrogenic in nature
- associated with Meigs syndrome
- asymptomatic
- unilateral pelvic pain or fullness
- small, hypoechoic, solid ovarian mass
- well-defined wall margins
- does not have posterior enhancement
- differential: fibroma, pedunculated fibroid, thecoma
8
Q
arteriovenous fistula
A
- vascular plexus of arteries and veins without an intervening capillary network
- pelvic surgery or trauma
- gestational trophoblastic disease
- malignancy
- menorrhagia, anemia, often diagnosed postabortion
- intramural uterine mass, flow reversal, multiple anechoic structures within myometrium
- differential: adenomyosis, trophblastic gestation, retained products
9
Q
leiomyoma
(fibroid)
A
- benign neoplasm of the uterine neoplasm of myometrium
- prevalence in african americans
- asymptomatic, menorrhigia, pelvic pain, bleeding, infertility
- well-defined
- anechoic to hyperechoic, heterogeneous when hemorrhagic, low flow velocity, may increase in size with estrogen stimulation
10
Q
cystadenocarcinoma
A
- epithelial neoplasm
- palpable pelvic mass
- unexplained weight gain
- pelvic pain
- multilocular, complex mass, irregular wall margins, ascities
- differential: cystadenoma, cystic teratoma, tubovarian abscess
11
Q
fibroma
(ovarian)
A
- rare, benign stromal tumor
- asymptomatic, pelvic pain, menopause, urinary or intestinal disturbance
- solid, hypoechoic adnexal mass
- dense mass
- posterior shadowing
- ascities
- 5-10 cm
- differential: pedunculated fibroid, teratoma, thecoma, brenner tumor
12
Q
adenomyosis
A
- ectopic endo tissue within the myometrium
- pelvic pain
- uterine enlargement and tenderness
- menorrhagia
- dysmenorrhea
- posterior uterine wall most commonly affected
- endo appears normal
- differential: degenerating fibroid and endo neoplasm
13
Q
thecoma
(ovarian)
A
- benign stromal tumor
- produces estrogen
- pelvic pain or pressure
- menopause
- hypoechoic mass
- prominent posterior shadowing
- differential: fibroma, teratoma, brenner tumor
14
Q
endometritis
A
- pelvic inflammatory disease
- retained products of conception
- postprocedural complication
- vaginitis
- pelvic pain, fever, leukocytosis
- normal findings, irregular endo, hypervascular endo and myometrium
- differential: normal uterus, adenomyosis, leiomyoma
15
Q
theca lutein cysts
A
- associated with high level of hCG
- gestational trophoblastic disease
- hyperstimulation syndrome
- asymptomatic, hyperemesis, abdominal bloating
- multilocular cystic structure
- bilalteral condtion
- differential: cystadenoma or hydrosalpinx
16
Q
uterine carcinoma
A
- associated with estrogen stimulation
- adenocarcinoma is most common
- risk factors: obesity, diabetes, nulliparity, postmenopause
- abnormal bleeding
- focal irregularity of the endo
- myometrial distortion
- thickened endo
- complex endometrial mass
- differential: endo hyperplasia or endo polyp
17
Q
polyp
A
- overgrowth of endo tissue
- unresponsive to progesterone
- asymptomatic, abnormal bleeding, infertility
- endo thickening
- round echogenic mass
- color flow demonstrates stalk
- differential: endo carcinoma, endo hyperplasia, submucosal leiomyoma
18
Q
serous cystadenoma
A
- epithelial neoplasm
- second most common benign tumor of the ovary
- rapid increase of pelvic mass
- pelvic pain
- irregular menses, bloating
- large, smooth walls, may contain debris, unilateral
- differential: hydrosalpinx, theca lutein cysts, hyperstimulation syndrome
19
Q
mucinous cystadenoma
A
- epithelial neoplasm
- pelvic pain, irregular menses, bloating
- multilocular anechoic mass, smooth margins, may contain debris
- differential: endometrioma, tuboovarian abscess, theca lutein cyst, cystadenocarcinoma
20
Q
submucosal leiomyoma
A
mass distorting the endo; least common but most likely to cause symptoms
21
Q
Meigs syndrome
A
combination of pleural effusion, ascites, and an ovarian mass that resolve after surgery
22
Q
polycystic ovarian disease
A
- endocrine imbalance, imbalance of LH and FSH
- irregular menses, hirsutism, infertility, obesity
- round, enlarged ovaries
- presence of ten or more follicles per ovary
- multiple, small peripheral cysts
- differential: functional cysts
23
Q
What is the most common uterine neoplasm?
A
intramural leiomyomas
24
Q
ovarian carcinoma
A
- epithelial or germ cell neoplasm
- risk factors: high-fat diet, infertility, nulliparity, family history
- asymptomatic, vague abdominal pain, palpable pelvic mass, GI symptoms, bloating
- soild, hypoechoic ovarian mass, irregular margins
- differential: endometrioma, metastatic lesion, granulosa cell tumor
25
Q
tamoxifen effect
A
- side effects of tamoxifen therapy
- asymptomatic
- abnormal bleeding
- normal appearing endo
- thickening of endo
- complex appearance to the endo
- differential: endo hyperplasia, polyp, carcioma, leiomyoma
26
Q
surface epithelial cyst
A
- arise from the cortex of the ovary
- asymptomatic
- pelvic pain
- small cluster of cysts
- differential: polycystic ovarian disease or cystadenoma
27
Q
nabothian cyst
A
- obstructed inclusion cyst
- chronic cervicitis
- asymptomatic
- round, anechoic structure, usually < 2cm
- differential: leiomyoma, arcuate vessel, retained products of conception
28
Q
cystic teratoma
(dermoid)
A
- arise from the wall of a follicle
- germ cell tumor
- contains fat, hair, skin, and teeth
- most common benign tumor of the ovary
- asymptomatic, abdominal pressure, mild pelvic pain, palpable mass
- tip of the ice burg
- complex
- commonly located superior to uterine fundus
- differential: endmetrioma, hemorrhagic cyst, serous cystadenoma, ectopic pregnancy
29
Q
hematocolpos
A
blood accumulation in the vagina
30
Q
hyperplasia
A
- unopposed estrogen
- tamoxifen therapy
- polycystic ovarian syndrome
- obesity
- abnormal bleeding
- asymptomatic
- premenopausal endo thickness >14mm
- postmenopausal endo thickness > 5mm
- differential: endo carinoma or endo polyp
31
Q
subserosal leiomyoma
A
mass found on the serosal surface of the uterus
