Uterine Pathologies Flashcards
**Leiomyoma:
Symptoms
Frequency and retention of urine; Iron-deficient anemia; Bleeding abnormalities; Reproductive difficulties; Obstipation(constipation) and rectal pressure; Infertility; Dysmeonorrhea and painful intercourse; Symptomless
**Leiomyoma:
Sonographic Appearance
distortion of uterine contour, well-defined, and vascularity in periphery
Uterine calcifications can be an indicator of…
hypertension, diabetes, or chronic renal failure
more commonly found in myomas (can be due to necrosis)and can be seen in arcuate vessels
**Adenomyosis:
Symptoms
hypermenorrhea, menorrhagia, metrorrhea, dysmenorrhea
**Diffuse Adenomyosis:
Sonographic Appearance
indistinct border between endometrium and myometrium, Swiss-cheese or honeycomb pattern, diffusely enlarged uterus, diffuse heterogeneity
**Focal Adenomyosis:
Sonographic Appearance
indistinct margins, myometrial cysts, internal Doppler vascularity
Arteriovenous Malformations:
Sonographic Appearance
serpiginous anechoic structures, subtle heterogeneous myometrium, tubular spaces within myometrium
Arteriovenous Malformations:
Symptoms
Women of childbearing years have metrorrhagia with blood loss and anemia
Arteriovenous Malformations show what type of flow pattern?
arterial flow: high velocity, low resistance
venous flow: high velocity, arterial component
also turbulent flow in myometrium
Leiomyosarcoma:
Symptoms
asymptomatic, uterine bleeding, pelvic pain
Leiomyosarcoma:
Sonographic Appearance
solid or mixed-solid texture, rapid growth, resembles myomas, common in fundus
Lipoleiomyoma:
Sonographic Appearance
echogenic, no Doppler flow, well-defined
Lipoleiomyoma:
Symptoms
NOT for FINAL
pelvic discomfort, palpable mass, irregular menses
**Endometrial Hyperplasia:
Symptoms
postmenopausal bleeding
**Endometrial Hyperplasia:
Sonographic Appearance
abnormal endometrial thickening, well-defined, cystic areas within endometrium
**Endometrial Polyps:
Symptoms
asymptomatic, uterine bleeding, menometrorrhagia in reproductive age
**Endometrial Polyps:
Sonographic Appearance
echogenic endometrial thickening, round echogenic mass within endometrial cavity, pedunculated with Doppler feeding vessel pattern
Endometritis:
Symptoms
lower abdominal pain, fever, dysmenorrhea
Endometritis:
Sonographic Appearance
irregular endometrium, enlarged ovaries with multiple cysts, dilated fallopian tubes, pus in cul-de-sac
**Endometrial Carcinoma:
Symptoms
postmenopausal bleeding, abdominal pain, association with estrogen replacement therapy
**Endometrial Carcinoma:
Sonographic Appearance
thickened endometrium ( >5mm), enlarged uterus, irregular low level echoes, endometrial fluid collection
**Synechiae:
Sonographic Appearance
bright endometrial echoes, easily identified with fluid distending endometrial cavity
Another name for Synechiae is…
Asherman’s Syndrome, endometrial adhesions
Another name for Leiomyoma is…
myoma or fibroid
dysmenorrhea
painful periods
dyspareunia
painful intercourse
hypermenorrhea
abnormal uterine bleeding
menorrhagia
heavy/long period
metrorrhagia
irregular bleeding
pyometra
pus filled uterus
polymenorrheic
cycle occurs at intervals of less than 21 days
oligomenorrheic
cycle prolonged for more than 35 days
amenorrhea
absence of menstruation
menometrorrhagia
excessive irregular bleeding
combination of metrorrhagia and menorrhagia
What is the most common gynecologic tumor?
leiomyomas/myomas/fibroids
**What is the most common gynecologic malignancy in North America?
Endometrial carcinoma
Large Endometrial Fluid Collections:
Symptoms
abdominal pain, enlarged abdominal mass, pressure
Large Endometrial Fluid Collections:
Sonographic Appearance
centrally cystic, round, moderately enlarged uterus
In postmenopausal women who are bleeding, what endometrial measurement would be considered safe?
less than 5mm
In postmenopausal women who are bleeding, what endometrial measurement would be considered suspicious?
greater than 5mm
In postmenopausal women who are not bleeding, what endometrial measurement would be considered safe?
less than 8mm
In postmenopausal women who are not bleeding, what endometrial measurement would be considered suspicious?
greater than 8mm
In postmenopausal women who are not bleeding, what endometrial measurement would not need a biopsy because the caner risk is low?
greater than 11mm
**What is the most common cause of abnormal uterine bleeding?
Endometrial hyperplasia
**The locations of leiomyomas are…
submucosal, intramural, subserosal, pedunculated, or intracavitary
**What are the demographics for leiomyomas?
more common in African American women
**Which leiomyoma location causes heavy bleeding?
submucosal and intracavitray
**What is the most common leiomyoma location?
intramural
What is the most common location of adenomyosis?
the posterior aspect
What are the risk factors for endometrial carcinoma?
obesity (causes changes in estrogen levels), diabetes, hypertension, or low parity (exposed to more estrogen than women with more births)
What is a good sonographic sign for endometrial carcinoma?
intactness of the inner layer of the endometrium (subendometrial halo) indicates superficial invasion
Why is the diagnosis for arteriovenous malformations critical?
D&C may lead to catastrophic hemorrhaging and could cause death
What are the demographics for adenomyosis?
most common with parous women in their late 30s and early 40s
What are the demographics for uterine leiomyosarcoma?
common in women 40-60 years old
What are differential considerations for an enlarged uterus?
pregnancy, postpartum, leiomyomas, adenomyosis, bicornuate or didelphic uterus
What are the differential considerations for a uterine tumor?
leiomyoma or carcinoma
What are the differential considerations for a thickened endometrium?
early intrauterine pregnancy, endometrial hyperplasia, retained products of conception/incomplete abortion, trophoblastic disease, endometritis, adhesions, polyps, inflammatory disease, endometrial carcinoma
What are the differential considerations for endometrial fluid?
endometritis, retained products of conception, PID, cervical obstruction
What are the differential considerations for endometrial shadowing?
gas/abscess, IUD, calcified myomas or vessels, retained products of conception
What is the premenopausal association with endometrial carcinoma?
anovulatory cysts (follicles grow but do not ovulate, but continues to divide and release estrogen encouraging cells to divide)
What is the postmenopausal association with endometrial carcinoma?
estrogen replacement theray
What could small endometrial fluid collections be a result of?
ectopic pregnancy, endometritis, degenerating myoma, recent abortion
