Uterine Pathology Flashcards
what two abnormalities may be indistinguishable from hyperplasia?
endo cancer and polyp
most common cause of abnormal uterine bleeding?
hyperplasia
in peri- and postmenopausal women
may be caused by unopposed estrogen hormone replacement therapy
during saline infusion sonohysterography what approach is used?
transvaginal
failure of fusion consists of?
uterus didelphys: complete dublication of uterus, cervix, and vagina
bicornuate uterus: most common Mullerian anomaly, single vagina, one or two cervices, and variable lake of fusion of upper uterine cavity
sonographic findings of endometritis
endo appears prominent, irregular, with small amount of fluid
pus in cul-de-sac
enlarge cystic ovaries
dilation of tube (5mm or more)
tubo-ovarian complex
Example of a persistant structure that arises from the caudal remnants of the mesonephric (Wollfian) duct?
gartners duct cyst
Rare malignancy arising from the myometrium?
leiomyosarcoma
may be indistinguishable from fibroid
clue is relatively rapid growth of mass in post-menopause
Clinical signs of leiomyomas
menometrorrhagia
frequent urination
enlarged uterus
increasing pain with degenerative changes
infertiliy or spontaneous abortions
alteration in normal menstrual flow
sonographic findings of cervical cancer
normal in early disease
enlarged uterus
similar to cervical myoma
hydronephrosis
involvement of other pelvic organs
What is failure of dissolution?
median septum fails to dissolve after fusion of the two separate Mullerian ducts, septate uterus
least severe Mullerian anomaly is a slightly protruding into the uterine cavity, arcuate uterus
The uterus, fallopian tubes and upper vagina develop from what?
Mullerian ducts
(paramesonephric ducts)
what is endometrial hyperplasia?
proliferation of endometrial glandular tissue
typical patient of adenomyosis
30-50 yrs old
dysmenorrhea and irregular bleeding
parous women
Exposure associated with poor pregnancy outcome, cervical cancinoma and breast carcinoma, and a T-shaped uterus?
DES (diethylstilbestrol) syndrome
Are the ovaries affected in the presence of mullerian anomalies?
No, do not develop from Mullerian ducts
most common gyn malignancy, usually occurs in postmenopausal women?
endometrial carcinoma
present with early postmenopausal bleeding
increased risk between estrogen and malignancy
third most common GYN malignancy?
cervical cancer
20-30 yrs old
most common symptom is post-coital bleeding
Failure of formation demonstrates?
complete agenesis:
absence of vagina, cervix, uterus, and fallopian tubes
partial agenesis:
range of anomalies, most common is unicornate uterus and single fallopian tube
hyperplasia clinical signs are similar to endo cancer, sonographic findings differ?
smooth boarders
more homogeneous
premenopause > 14mm
tamoxifen > 10mm
postmeno estrogen only > 5mm
postmeno w/ estrogen and progesterone > 8mm
Commonly acquired after surgical procedure or uterine trauma and associated with heavy vaginal bleeding?
uterine arteriovenous malformation
causes of endometritis
PID
retained products
postprocedural complication
vaginitis
In the case of uterine anomalies, what other system should be evaluated for anomalies?
urinary system
abnormality found in posttraumatic or postsurgical historiesincluding uterine curettage?
synechiae or ashermans syndrome
sonographic findings associated with synechiae
bright echoes within endo
better identified during secretory phase or under SIS
bridging bands of tissue that distort cavity
What are the four categories of anomalous internal genitalia development?
failure of formation
failure of fusion
failure of dissolution
failure of structures to disappear
risks associated with endometrial cancer
obesity and anovulatory cycles
estrogen replacement
history of hyperplasia
tamoxifen therapy
family history
