Uterine Pathology Flashcards
The 3 types of congenital anomalies of the uterus
- arrested development
- failure of fusion
- failure of resorption
Unicornuate uterus
Arrested development
Bicornuate and uterine didelphys
Failure of fusion
Septate and sub septate
Failure of resorption
Partial vagina only, cervix, upper vagina and uterus are missing
MRKH syndrome
When the uterus descends down the vagina
Prolapsed uterus
Endometrial lining is replaced by fibrous adhesions
Asherman’s syndrome
A form of asherman’s where there is a scar on the uterine lining
Synechiae
This malformation causes menorrhagia and is difficult to see until you use doppler
Arteriovenous malformation (AV)
Multiplication of abnormal cells, can be malignant or benign
Neoplasia
Thick, hyperechoic endometrium either focal or diffuse that causes irregular bleeding just after menarche or before menopause
Endometrial hyperplasia
Endometrium measuring 7-14mm
Secretory
Endometrium measuring 4-8mm
Proliferative
Post menopausal endometrium >5mm
Abnormal
What phase in the menstrual cycle should be scanned when investigating for endometrial hyperplasia?
Early proliferative
Endometrial growth extending into the canal from a stalk
Endometrial polyps
Extension of endometrial tissue into the myometrium, usually in the posterior wall
Adenomyosis
How can you differentiate between uterine varices and ovaries?
Colour doppler
Inflammation of the endometrium
Endometritis
Most common tumour in the female pelvis
Leiomyoma (fibroid)
Benign neoplastic mass of fibromuscular tissue
Leiomyoma (fibroids)
Malignant fibroid
Leiomyosarcoma
Fibroids confined to the myometrium, also the most common.
Intramural
Fibroids projecting into the uterine cavity
Submucosal
Fibroids that project from perimetrium
Subserosal
Hypoechoic with high attenuation, overall enlarged uterus with an irregular contour, calcification present in older patients
Sonographic appearance of fibroids
Lipocytes and fibromuscular tissue
Lipoleiomyoma
Leiomyosarcoma and endometrial carcinoma
Malignant uterine neoplasia
Rare, may arise from a pre-existing fibroid with the same symptoms as fibroids
Leiomyosarcoma
Degenerative fibroid appearance with possible local invasion of surrounding organs or hepatic metastases
Sonographic appearance of leiomyosarcoma
90% of all uterine malignancies are this
Endometrial carcinoma
- Confined to endometrium
- Confined to uterus
- Spread beyond uterus but still in pelvis
- Distal metastasis (ie. liver)
Stages of endometrial carcinoma
HRT, obesity, hypertension, diabetes, PCOS, granulosa cell tumours of the ovary
Increased risk for endometrial carcinoma (endo CA)
Causes a bizarre endometrium, used in the treatment of breast cancer and is an estrogen antagonist
Tamoxifen
A bicornuate uterus is identified on a pelvic ultrasound. Which other organ could have congenital abnormalities and should be included in this study?
Kidneys
Upper limit of normal for the endometrium in the reproductive age population?
14mm
Which type of lieomyoma is the most common cause of infertility?
Submucosal
Which population of patients have a higher risk of developing endometrial cancer?
Postmenopausal
Synechiae
Arteriovenous (AV) malformation
Endometrial hyperplasia
Endometrial polyps
Prominent arcuate vessels
Uterine varices
Endometritis
- Intramural fibroid
- Subserosal fibroid
- Submucosal fibroid
Fibroids/leiomyoma
Tamoxifen therapy
