Female GU Pathology II: Uterus Flashcards Preview

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Flashcards in Female GU Pathology II: Uterus Deck (32):
1

Consists of bundles of smooth muscle

Myometrium

2

Composed of endometrial glands and surrounding stroma, responsive to hormone stimulation, and undergoes monthly shedding

Endometrium

3

Endometritis

Inflammation of the endometrium

4

What is characteristic of acute endometritis?

Abnormal presence of neutrophils

5

What is characteristic of chronic endometritis?

Plasma cells are diagnostic

6

What are some possible causes of endometritis?

- Infection
- Abortion
- Delivery
- IUDs
- STDs

7

What are some complications of endometritis?

– Infertility
– Ectopic pregnancy

8

What are common causes of pelvic inflammatory disease?

• Chlamydia trachomatis
• Neisseria gonorrhoeae

9

What is the clinical presentation of PID?

Purulent cervical discharge, cervical motion tenderness

10

Endometriosis

Endometrium glands or stroma presents in abnormal locations outside the uterus

11

What is the pathogenesis of endometriosis?

Multiple theories but regurgitation is favored - Menstrual backflow though fallopian tubes leads to implantation with decreased immune clearance.

12

Adenomyosis

The presence of endometrial glands and surrounding stroma deep WITHIN the myometrium.

13

With what can "chocolate" cysts be seen in?

Endometriosis

14

What can be seen in the uterus with adenomyosis?

Uterus can enlarge due to myometrial hypertrophy

15

What is the main cause of endometrial hyperplasia?

Excess estrogen

16

What is the risk of endometrial cancer in nontypical endometrial hyperplasia?

Low risk

17

What is the risk of endometrial cancer in atypical endometrial hyperplasia?

High risk - this is AKA Endometrial Intraepithelial Hyperplasia

18

What is the clinical presentation of endometrial hyperplasia?

Abnormal uterine bleeding or postmenopausal bleeding

19

What is the most frequently altered gene in endometrial carcinoma?

PTEN

20

What is the most common invasive cancer of the female genital tract?

Endometrial Carcinoma

21

What is the most common type of endometrial carcinoma?

Endometrioid

22

What is the main risk factor for endometriod endometrial carcinoma?

Unopposed estrogen - many sources (obesity, early menarche, late menopause, DM, HTN)

23

What does serous endometrial carcinoma arise from?

Usually arises from atrophic endometrium

24

What is seen on histology of serous endometrial carcinoma?

Papillary Structures

25

What drug are endometrial polyps associated with?

Tamoxifen

26

A 37‐year‐old woman has had dysmenorrhea for 8 months. On pelvic examination the uterus appears symmetrically enlarged. This microscopic appearance is representative of her myometrium. Which of the following is the most likely diagnosis?

A. Adenomyosis
B. Endometriosis
C. Endometritis
D. Invasive endometrioid carcinoma
E. Invasive secretory carcinoma

A. Adenomyosis

27

Leiomyoma

Most common BENIGN tumor in females that arises from myometrial smooth muscle cells

28

What is the histological appearance of leiyomyomas?

Well-delineated, whorled bundles of smooth muscle cells, resembling the surrounding normal myometrium

29

Leiomyosarcoma

Uncommon tumors, arise de novo from either myometrial layer or endometrial stroma - do NOT arise from benign leiomyomas

30

What is the prognosis of leiomyosarcoma?

Poor

31

A 14‐year‐old girl has had irregular menstrual cycles for 6 months. She had menarche at age 12. There are no abnormal physical examination findings. An endometrial biopsy is taken on calculated post‐ ovulatory day 9 and shows proliferative phase endometrium. Which of the following is the most likely diagnosis?

A. Adenomyosis
B. Anovulatory cycles
C. Acute endometritis
D. Endometrial adenocarcinoma
E. Leiomyomata

B. Anovulatory cycles

32

What is the most common cause of abnormal uterine bleeding in adolescents?

Anovulatory Cycles

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