13.4 Endometrium and Myometrium

Question 1

What hormone controls endometrial growth?

Answer 1

Estrogen

Question 2

Asherman Syndrome

Answer 2

Secondary amenorrhea due to loss of basalis layer of endometrium

Question 3

Where are the stem cells of the endometrium?

Answer 3

Basalis Layer

Question 4

What is a cause of Asherman syndrome?

Answer 4

Overaggressive dilation and currettage

Question 5

Anovulatory Cycle

Answer 5

Lack of ovulation due to a lack of the progesterone driven secretory phase

Question 6

When are anovulatory cycles often seen?

Answer 6

Menarche and Menopause

Question 7

How does acute endometritis present?

Answer 7

Fever with abnormal uterine bleeding and pelvic pain

Question 8

What is a common cause of acute endometritis?

Answer 8

Often due to retained products of conception

Question 9

What is characteristic of chronic endometritis?

Answer 9

Plasma Cells

Question 10

What are some common causes of chronic endometritis?

Answer 10

• Retained products of conception
• PID
• Infection

Question 11

Endometrial Polyp

Answer 11

Hyperplastic protrusion of endometrium

Question 12

What is a drug that can cause endometrial polyps?

Answer 12

Tamoxifen

Question 13

What is the presentation of endometrial polyps?

Answer 13

Abnormal uterine bleeding

Question 14

Endometriosis

Answer 14

Endometrial glands and stroma outside of the uterine endometrial lining

Question 15

Regurgitation Theory of Endometriosis

Answer 15

Retrograde menses products go back up the tubes leading to endometriosis

Question 16

Metaplastic Theory of Endometriosis

Answer 16

Mullerian duct has metaplasia

Question 17

Lymphatic Theory of Endometriosis

Answer 17

Lymphatic seeding of endometriosis - can be found in strange sites like the lung

Question 18

Adenomyosis

Answer 18

Endometriosis of the myometrium - glands of the endometrium are found within the myometrium

Question 19

What does endometriosis increase the risk for?

Answer 19

Ovarian Carcinoma

Question 20

Endometrial Hyperplasia

Answer 20

Due to unopposed estrogen leading to hyperplasia of the endometrial glands relative to the stroma - often seen with obesity

Question 21

What is the most important predictor for the progression of endometrial hyperplasia to cancer?

Answer 21

Cellular Atypia

Question 22

Endometrial Carcinoma

Answer 22

Malignant proliferation of endometrial glands

Question 23

What is the hyperplasia pathway to endometrial carcinoma?

Answer 23

Excess high estrogen leads to hyperplasia of the endometrium which can eventually lead to carcinoma - endometrioid histology

Question 24

What is the sporadic pathway to endometrial carcinoma?

Answer 24

Carcinoma develops from an atrophic endometrium - serous histology with papillary structures

Question 25

What is the typical age where serous endometrial carcinoma occurs?

Answer 25

~70 yrs

Question 26

What is the typical age where endometrioid carcinoma occurs?

Answer 26

~50-60 yrs

Question 27

What mutations are commonly seen in the sporadic pathway of endometrial carcinoma?

Answer 27

p53 mutations

Question 28

Which pathway of endometrial carcinoma will have psamomma bodies?

Answer 28

Sporadic Pathway

Question 29

Leiomyoma

Answer 29

Benign proliferation of smooth muscle arising from myometrium that is related to estrogen exposure

Question 30

What are the differences in leiomyoma and leiomyosarcoma?

Answer 30

- Leiomyomas are multiple - Leiomyomes are white and whorled - Leiomyosarcomas are see in postmenopausal women

Question 31

Leiomyosarcoma

Answer 31

Arises denote and are malignant proliferation of smooth muscles arising from the myometrium