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OBGYN BOARD > GYN Pathology > Flashcards

GYN Pathology Flashcards

1
Q

Mullerian ducts

A

The uterus, fallopian tubes and upper vagina develop from the Mullerian ducts (paramesonephric ducts).

Most uterine and cervical anatomical variants are caused by failure of development of Mullerian ducts at some stage of development

Because of the close developmental relationship between the genital ducts and urinary system, there is a common association of anomalies of both systems.
-Should evaluate the urinary tract in all cases of uterine anomalies!

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2
Q

Uterine agenesis

A

Failure of the caudal mullerian ducts to develop

Fallopian tubes are present but not uterus

Amenorrhea

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3
Q

Arcuate Uterus

A

Septum between mullerian ducts is almost completely reabsorbed with only mild indentation of endo of the fundus

Least severe anomaly

Can be asymptomatic or cause infertility

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4
Q

Bicornuate Uterus

A

Partial fusion of the mullerian ducts

Two uteri in the superior portion of the uterus

Two superior endometrial cavities

Can be asymptomatic or cause infertility and spontaneous abortion

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5
Q

Didelphys Uterus

A

Complete failure of the mullerian ducts to fuse

Complete duplication of uterus, cervix, and vagina

Asymptomatic

Infertility, spontaneous abortion and vaginal septation can occur

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6
Q

Septate Uterus

A

Complete fusion of the mullerian ducts with failure to completely reabsorb the septum

Two uterine cavities and one uterine fundus

Asymptomatic

High incidence of infertility and multiple spontaneous abortions

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7
Q

Subseptate Uterus

A

Complete fusion of the mullerian ducts with partial failure to completely reabsorb the septum

Asymptomatic

Infertility can occur, as well as multiple spontneous abortions

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8
Q

Unicornuate Uterus

A

Unilateral development of the paired mullerian ducts

Asymptomatic, hypomenorrhea, and infertility can occur

Small uterine size and lateral uterine position

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9
Q

Leiomyoma

A

Also known as a fibroid, myoma or fibromyoma

Most common tumor of the female pelvis

They are benign, smooth muscle tumors which are usually multiple and have greater incidence in black, nulliparous women

Usually located in uterine corpus but can also be found in the cervix and broad ligament

Described by their location in relationship to uterine wall:

  • Submucosal: beneath the endo cavity and often projects into uterine cavity; most commonly produce symptoms (uterine bleeding); distorts endo
  • Intramural/ interstitial: within the myometrium; distorts myometrium
  • Subserosal: Beneath the perimetrium; distorts uterine contour
  • Intraligamentous: between the layers of the broad ligament
  • Cervical: uncommon
  • Pedunculated: On a pedicle or stalk; only occurs with submucosal and subserosal; torsion may occur
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10
Q

Clinical findings of a leiomyoma

A
  • Often asymptomatic
  • Heavy periods (menometrorrhagia) especially with submucosal myomas
  • Frequent urination
  • Enlarged uterus on pelvic exam
  • Increasing pain with degenerative changes
  • Infertility or spontaneous abortions
  • Alteration in normal menstrual flow
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11
Q

Sonographic findings of leiomyoma

A

Dependent on amount of degeneration, size and location of fibroid

  • Well circumscribed hypoechoic mass
  • Lobulated uterine contour
  • Shadowing (with increased attenuation and calcific degeneration)
  • Displacement of endometrial echoes
  • Extrinsic compression of posterior bladder wall
  • Pedunculated fibroid may appear as hypoechoic adnexal mass
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12
Q

Adenomyosis

A

Benign invasion of endometrial glands and stroma into the myometrium

Can be diffuse or focal and most often affects posterior myometrium

Risk factors:

  • Multiparity
  • Elevated estrogen
  • Aggressive curettage
  • Women ages 30-50

Clinical findings:

  • Pelvic pain/cramping
  • Uterine enlargement & tenderness on physical exam
  • Menorrhagia
  • Dysmenorrhea

Sonographic findings:

  • Enlarged uterus with normal contours
  • Asymmetric thickening of anterior and posterior uterine wall
  • Myometrial cysts (2-6 mm)
  • Inhomogeneous myometrium
  • “Venetian blind” type shadowing
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13
Q

Cervical carcinoma

A

Second most common GYN malignancy

Typically seen in women ages 20-30

Symptoms:

  • Post-coital vaginal bleeding (most common)
  • Palpable mass
  • Weight loss
  • Vaginal discharge
  • Asymptomatic

Risk factors:

  • HPV infection
  • Early sexual activity
  • Multiple sex partners
  • Smoking
  • OCP use

Sonographic findings:

  • Normal appearance in early disease
  • Enlarged/ bulky cervix
  • May appear similar to cervical myoma
  • Hydronephrosis
  • Involvement of other pelvic organs
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14
Q

Nabothian cyst

A

Mucus retention cyst due to obstructed and dilated endocervical glands

Common, benign and of no clinical significance

Sonographic findings:

  • Small, well circumscribed, anechoic structure located within cervical wall
  • Posterior acoustic enhancement
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15
Q

Hydrometra

A

Collection of serous fluid within endo cavity

May be secondary to:

  • Cervical stenosis (esp. post-menopausal pts)
  • Endometrial ablation
  • Pelvic radiation therapy
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16
Q

Uterine Arteriorvenous malformation (AVM)

A

May be congenital but more commonly acquired after surgical procedure or uterine trauma

Associated with heavy vaginal bleeding

Sonographic findings:

  • Hypoechoic myometrial abnormality
  • Abundant flow on color doppler
  • Low resistance, high velocity flow on spectral doppler
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17
Q

Endometrial carcinoma

A

Most common GYN malignancy

Associated risk factors:

  • Obesity
  • Postmenopausal (75-80% of cases) with an increased risk if on estrogen replacement therapy
  • History of atypical hyperplasia of endo
  • History of Tamoxifen therapy
  • Strong family history of uterine cancer

Clinical signs:

  • Postmenopausal vaginal bleeding
  • Hypermenorrhea, intermenstrual flow in patients still having periods
  • Pain as result of uterine distension

Sonographic findings:

  • Alteration in size, shape, and sono texture of uterine parenchyma
  • Increased uterine size
  • Inhomogencity and thickening of endo echoes ( >4-5 mm)
  • Fluid in endo cavity
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18
Q

Endometrial hyperplasia

A

Proliferation of endometrial glandular tissue that can be focal or diffuse

25 % of patients with atypical hyperplasia will undergo malignant changes (progressing to endo carcinoma)

Most common cause of abnormal uterine bleeding

Causes:

  • Unopposed estrogen hormone replacement therapy
  • Persistent anovulatory cycles
  • PCOS
  • Obesity
  • Estrogen producing tumors of the ovary (granulosa cell tumor and thecomas)

Sonographic findings:

  • Smooth borders
  • Prominent thickening of the endometrium with/without cystic changes
  • More homogenous texture
  • Premenopausal women thickness >14 mm
  • Patient on Tamoxifen >10 mm
  • Postmenopausal women on estrogen only >5 mm
  • Postmenopausal women in estrogen phase can be up to 8 mm, and when in progesterone phase, will decrease
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19
Q

Endometrial polyps

A

Localized overgrowths of endometrial tissue which may be pedunculated, broad-based, or have a thin stalk.
-Occasionally, the stalk will be so long that it will prolapse into the cervix or even the vagina

Clinical signs:

  • Usually asymptomatic
  • Infertility
  • Abnormal uterine bleeding
  • Usually discovered by accident in D&C
  • Occasionally causes postmenopausal bleeding

Sonographic findings:

  • Non-specific thickened endo, usually focal but can be diffuse
  • Discrete mass in endo, focal, round and echogenic
  • Possibly vascular stalk demonstrated with Color Doppler
  • May indistinguishable from endometrial hyperplasia
  • Sonohysterography is ideal for demonstrating size and location
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20
Q

Endometritis

A

Causes:

  • Pelvic inflammatory disease
  • Retained products of conception
  • Postprocedural complication
  • Vaginitis

Clinical signs:

  • Pelvic pain
  • Fever
  • Leukocytosis

Sonographic findings:

  • Thick and irregular endo
  • Pronounced endo
  • Enlarged, inhomogeneous uterus
  • Hypervascular endo and myometrium
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21
Q

Saline Infusion (Sonohysterography- SIS)

A

A technique of introducing saline into the endo cavity to evaluate the endo with ultrasound.

  • Images are obtained in two planes
  • External os is cleansed and catheter is placed into cervix
  • Sterile saline is infused during TV ultrasound

Indications for exam:

  • Infertility and habitual abortion
  • Congenital anomalies and/or anatomical variants of uterine cavity
  • Pre and post-op evaluation of uterine cavity (esp. w/ myomas, polyps, and cysts)
  • Suspected uterine cavity synechiae (scarring associated with Asherman’s syndrome)
  • Further evaluation of abnormalities detected by US

***Asherman’s syndrome= adhesions from previous deep curettage or endo infection

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22
Q

Physiologic cysts

A

Simple (anechoic, unilocular, thin-walled) cystic mass related to either ovary measuring less than 3 cm (WNL)

Approximately 60% of ovarian cysts resolve spontaneously

Functional cysts that are benign:

  • Follicular
  • Corpus luteal
  • Theca lutein
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23
Q

Follicular cysts

A

Caused by over-stimulation of a follicle that fails to rupture/ involate

Serous fluid-filled cyst that measures 3-8 cm

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24
Q

Corpus luteal cyst

A

Occur following ovulation of dominant follicle

In absence of pregnancy, may continue to grow or hemorrhage into lumen (rarely exceed 4 cm in diameter)

Secrete progesterone and small amounts of estrogen

Normally persist during pregnancy, usually resolving by 16 weeks

Sonographic findings:

  • thick hyperechoic, irregular walls
  • usually echogenic internal content
  • possible solid appearance
25
Q

Theca lutein cysts

A

Result of over-stimulation by high levels of hCG associated with gestational trophoblastic disease or hCG administration during infertility treatment

Largest of the functional cysts

Multilocular and bilateral

May persist for a few days/weeks but generally resolve without surgery

26
Q

Hemorrhagic cysts

A

Ovarian cyst that hemorrhages into the lumen because of its large size, spontaneous rupture or torsion

Patient’s present with sudden onset of pelvic pain

Sonographic findings:

  • Typical cystic characteristics
  • Acute hemorrhage= hyperechoic, mimicking solid mass but with posterior acoustic enhancement
  • Subacute= complex appearance with internal echoes, strands, rarely a fluid-fluid level
  • Sono appearance will vary with time with clot lysis
27
Q

Paraovarian/ Parovarian cysts

A

Result from persistent developmental remnants of Wolffian ducts

Not ovarian in origin but located adjacent to ovary and may be mistaken for ovarian cysts

Sonographic findings:

  • Simple cystic characteristics
  • Thin wall
  • Located adjacent to ovary
  • Attempt to demonstrate cyst separate from ovarian tissue
28
Q

Epithelial Tumors

A

Tumors arising from the surface epithelium that covers the ovary

Account for 65-75% of all ovarian neoplasms and approximately 90% of all ovarian malignancies

Divided into 5 categories based on epithelial differentiation

1) Serous
2) Mucinous
3) Transitional cell (Brenner)
4) Endometroid
5) Clear cell

29
Q

Serous Tumor

A

Common, accounting for 25-30% of all ovarian neoplams

  • 50 to 70%= benign, sometimes bilateral and occur most commonly in women 40-50 years old
  • 40 to 50%= malignant (serous cystadenocarcinoma)- bilateral 50% of time and occur commonly in peri/post-menopausal women
  • *Usually smaller than mucinous tumors

Sono findings of benign:

  • Sharply marginated
  • Anechoic
  • Large but usually unilocular
  • Possibly internal thin-walled septations

Sono findings of malignant:

  • Multilocular
  • Multiple papillary projections/septations
  • Occasionally echogenic material within
  • Possible multiple echogenic foci
  • Ascites
30
Q

Mucinous Tumor

A

Benign:

  • Comprise 20-25% of all benign ovarian neoplasms
  • More common in women 30-50 years old
  • Very rare bilateral
  • Sono findings:
  • Multiloculated with thicker and more numerous septations
  • Fine, gravity-dependent echoes
  • Up to 50 cm in diameter

Malignant:
-Account for only 5-10% all malignant primary neoplasms
-Occur most frequently in women 40-70 years old
-15 to 20% are bilateral
Sono findings:
* Multiloculated cystic lesions measuring 15-30 cm in diameter
*Contain echogenic material and papillary excrescences

31
Q

Transitional Cell (Brenner) Tumor

A

Also called ovarian fibroepithelioma

Account for only 1-2% of all primary ovarian tumors

Almost always benign

Women 40-80 years old (most frequently in their 50’s)

Small percent are bilateral

Most are smaller than 2 cm

Sono findings:

  • Hypoechoic solid mass, may have small cystic spaces
  • Calcifications may be present
  • May mimic ovarian fibroma
32
Q

Endometroid Tumor

A

80% are malignant but have better prognosis than serous or mucinous carcinomas

Identical to endometrial adenocarcinoma
-30% of patients with this tumor have associated endometrial cancer

Sono findings:

  • Mixed cystic and solid mass
  • In some cases, there may be predominately solid mass, possibly with areas of hemorrhage/ necrosis
  • May have associated endometrial abnormality
33
Q

Clear Cell Tumor

A

Nearly always malignant

Occur in women 50-70 years old

Bilateral (20% of time) and range in size up to 30 cm

Variant of endometroid and serous carcinomas

Sono findings:

  • Non-specific
  • Complex predominately solid mass
34
Q

Germ cell tumors

A

Derived from primitive germ cells of embryonic gonad and account for 20% of all ovarian neoplasms

Adults:

  • Majority are benign
  • 95% being cystic teratomas

Children/Adolescents:

  • > 60% of ovarian neoplasms are of germ cell origin
  • 1/3 are malignant

Three types:

1) Benign cystic teratoma (BCT)/ Dermoid
2) Dysgerminoma
3) Endodermal Sinus (Yolk Sac) Tumor

35
Q

Benign Cystic Teratoma (BCT)/ Dermoid cyst

A

Most common germ cell tumor (15-25% of ovarian neoplasms)

Usually reproductive age women

Composed of three germ layers (endoderm, mesoderm, ectoderm) and is bilateral up to 15% of time

Usually asymptomatic and found incidently

Most common complication is ovarian torsion, and less common is rupture. Symptoms can include:

  • Abdominal pain (esp. with torsion)
  • Abdominal mass/ swelling
Immature teratomas (teratocarcinoma) is very rare 
-rapidly growing solid malignant tumors that most commonly occur in first 2 decades of life

Sono findings:

  • Predominately cystic adnexal mass
  • Complex mass with calcifications
  • Fat-fluid level (move pt around to see)
  • Diffusely echogenic
  • “Tip of the iceburg” - highly echogenic mass that shadows and obscures posterior wall of lesion
  • “Dermoid plug” - predominately cystic mass with echogenic mural nodule, typically casting acoustic shadow
  • “Dermoid mesh” - multiple echogenic linear interfaces floating within cystic mass (hair fibers)
36
Q

Dysgerminoma

A

Malignant germ cell tumor (bilateral 15% of time)

Originates from primordial germ cells of the ovary

3-5% of all ovarian malignancies

Primarily women 30 years and younger

Highly malignant but highly radiosensitive
-5 year survival rate up to 90%

Sono findings:

  • Multiloculated solid mass, size variable’
  • May be bilateral
37
Q

Endodermal Sinus (Yolk Sac) Tumor

A

2nd most common germ cell malignancy

Occur in young adulthood (20-30’s)

Usually unilateral and vary in size

Highly malignant and metastasize to surrounding structures

Patients have increased levels of serum AFP

Sono findings:
-Predominately solid mass with necrosis

38
Q

Sex Cord Stromal Tumors

A

Arise from sex cords of embryonic gonad or ovarian stroma

1/2 of these tumors are fibromas

Approximately 8% of all ovarian tumors

Four types:

1) Fibroma
2) Granulosa cell
3) Thecoma
4) Sertoli-Leydig

39
Q

Fibroma

A

Benign and occur all ages (most frequently in 40-50’s)

Usually unilateral and range from microscopic to very large in size

Ascites with fibromas over 10 cm

Sono findings:

  • Homogeneous hypoechoic mass with posterior acoustic enhancement (highly attenuating)
  • Rarely focal or diffuse calcifications
  • Associated with ascites and pleural effusion
  • Similar to pedunculated fibroid or Brenner tumor
  • **Meig’s Syndrome
  • Association of ascites and pleural effusion with fibrous ovarian tumor (fibroma)
  • Disappears after excision of tumor
40
Q

Granulosa Cell Tumor

A

95% are of the adult type

Most often in women 50-55 years old

Tumors commonly produce estrogen

Juvenile tumors result in precocious puberty

Sono findings:

  • Small tumors predominately solid, similar to uterine fibroids
  • Large tumors multiloculated and cystic, similar to cystadenomas
  • Possibly abnormally thick endo secondary to hormonal stimulation
41
Q

Thecoma

A

Estrogen producing tumors that are most common in post-menopausal women who present with clinical signs of estrogen/androgen activity

97% of cases are unilateral and rarely malignant

Range in size from small to 5-10 cm

Sono findings:

  • Solid hypoechoic ovarian mass with posterior acoustic enhancement
  • Possibly abnormally thick endo secondary to hormonal stimulation
42
Q

Sertoli-Leydig Tumor

A

Also called Arrhenoblastoma/ Androblastoma

Rare tumor that is unilateral and typically occur in women under age of 30

Up to 20% are malignant

Androgen (testosterone) producing and approximately 50% of pts present with symptoms of masculinization

Most are 5-15 cm

Sono findings:

  • Solid echogenic mass
  • Similar appearance to granulosa cell tumor
43
Q

Metastatic Tumors

A

Usually bilateral solid ovarian mass that accounts for 5-10% of ovarian tumors

Most common sites for metastases are tumors of the breast and GI tract

Tumors spread to ovary by several routes:
-Direct invasion
~Occurs usually from carcinomas of the uterus and fallopian tubes
~Occurs occasionally from malignancies of colon and retroperitoneum
-Peritoneal fluid
~Carries malignant cells from anywhere in peritoneal cavity
-Blood vessels and lymphatics
~Bring malignant cells from more distant sites

44
Q

Krukenburg Tumors

A

Type of ovarian metastatic tumor/cancer that arises from GI primarily (usually gastric carcinoma) but also from colon or appendix

Usually bilateral and more common on the right if unilateral

Cannot be distinguished from primary carcinoma on ultrasound

Sono findings:

  • Bilateral solid hypoechoic or complex predominately solid masses
  • Possible ascites
45
Q

Polycystic Ovarian Syndrome (PCOS)

A

Also called Stein-Leventhal Syndrome

Endrocrinologic disorder associated with chronic anovulation which is usually diagnosed in women in their late teens and early 20’s

Diagnosis of PCOS is actually made based on clinically and serologic findings (not necessarily US)

Clinical signs:

  • Infertility
  • Obesity
  • Amenorrhea
  • Hirsutism

Sono findings:

  • Bilateral multiple cysts (<1 cm) throughout subcapsular and stromal ovarian tissue (>/= 12-19 follicles per ovary)
  • Ovarian volume > 10 cm cubed
  • Small symmetrical cysts in the periphery “string of pearls”
  • Always bilateral
46
Q

Ovarian Torsion

A

Partial or complete rotation of the ovarian pedicle on its axis which leads to lymphatic and venous drainage being compromised, causing congestion and edema of the ovary, eventually leading to loss of arterial perfusion and resultant infarction

Clinical Presentation:

  • Typically sudden onset of pelvic pain
  • Right sided torsion can clinically mimic acute appendicitis

Risk Factors:

  • Pre-existing ovarian cyst or mass (usually benign)
  • Children and young females with mobile adnexa (ovary usually normal)
  • Pregnancy

Sono findings:
-Enlarged ovary, often with multiple follicles
-Doppler findings depend on degree and chronicity of torsion
~Absent color and spectral Doppler flow
~Dampened arterial flow (compare both ovaries)
~Possible arterial Doppler flow but absent venous flow
~”Whirlpool sign” = twisted ovarian vessels
-Possible adnexal mass

47
Q

Endometriosis

A

Presence of functional endometrial tissue outside of the endometrium and myometrium which responds to the hormonal influence of the ovulatory cycle

Benign proliferative disease that may cause severe pain or may be asymptomatic

Most commonly found:

  • Ovaries (80% of cases)
  • Fallopian tubes
  • Broad ligament
  • Posterior cul-de-sac
  • Pelvic peritoneum

More common in:

  • Caucasians
  • Women of reproductive age
  • Women of higher socioeconomic status who postpone having children until later in life

Clinical signs:

  • Chronic pain
  • Infertility
  • Dysmenorrhea
  • Dyspareunia
  • Dysuria
  • Dyschezia (difficult defecation)
48
Q

Two forms of endometriosis

A

1) Diffuse: scattered minute implants
- Rarely detectable by ultrasound

2) Localized: endometrioma, which is a discrete mass sometimes called a chocolate cyst
- Hypoechoic, homogeneous mass
- Thick, well-defined, sometimes slightly irregular walls
- May be solid, cystic or complex
- Fluid/Fluid level

49
Q

Pelvic Inflammatory Disease (PID)

A

Inflammation of pelvic and adnexal structures which is typically from an infection that spreads from cervix through the endometrial cavity to the fallopian tubes and adnexa

Most often sexually transmitted from:

  • Chlamydia
  • Gonorrhea
  • E. Coli

Can also be caused from pathogens introduced by:

  • HSG
  • D&C
  • Ruptured appendix
  • Diverticulitis
  • Abortion
  • Postpartum

Inflammation can be localized or diffuse

Predisposes women to infertility, tubal scarring and ectopic pregnancy

Clinical signs:

  • Fever
  • Leukocytosis
  • Lower abdominal pain
  • Purulent vaginal discharge
  • Pelvic tenderness (Bilateral/diffuse)
  • Cervical motion tenderness
  • Constant dull pain worsened by sexual activity
50
Q

Stages of PID

A

1) Early PID- endometriosis
Sono findings:
-Thickening and irregularity of endo
-Fluid, debris, or gas within endo cavity
-Diffuse hypoechogenicity of uterus
-Indistinct borders of pelvic structures
-Fluid in posterior cul-de-sac (may be complex)
2) Subacute/Acute salpingitis: may produce pyosalpinx
Sono findings:
-Pyosalpix= dilated, enlarged tube with debris/ echogenic material
-Tubular adnexal cystic masses
-Shaggy tubal walls
-Usually unilateral but may be bilateral
3) Severe PID: broad ligament and ovarian involvement
-If purulent material leaks out of fimbriated end of the tube, TOA may result
-Patient may also develop peritonitis and acute perihepatitis (Fitz-Hugh-Curtis syndrome)

Sono findings:
-TOA= complex adnexal mass(es) uni/bilateral with hyperemic flow on Doppler
-Indistinct walls surrounding the mass
~ Tubo-ovarian complex (TOC)- visible tube and ovary, inflamed, no abscess
4) Chronic
-Long standing, subacute condition which follows acute PID
-Adhesions may cause pelvic organs to merge centrally, leading to the “indefinite uterus sign”

51
Q

Hydrosalpinx

A

Collection of simple serous fluid within a scarred or obstructed fallopian tube

Can occur because of:

  • PID
  • Endometriosis
  • Post-op adhesions

Clinical findings:

  • Asymptomatic
  • Pelvic fullness
  • Infertility
52
Q

Pyosalpinx

A

Accumulation of pus in the fallopian tube

Caused by:

  • Bacterial infection
  • Diverticulitis
  • Appendicitis

Clinical findings:

  • Asymptomatic
  • Low grade fever
  • Pelvic fullness
53
Q

Salpingitis

A

Inflammation of the fallopian tube

Caused by:
-Pelvic infection

Clinical findings:

  • Pelvic pain
  • Fever
  • Dyspareunia
  • Leukocytosis
54
Q

Tuboovarian Abscess (TOA)

A

Infection that involves the fallopian tube and the ovary

Caused by:

  • Pelvic infection
  • STD’s

Clinical findings:

  • Severe pelvic pain
  • Fever
  • Leukocytosis
  • Nausea/ vomiting
55
Q

Hydrocolpos

A

Generic term for the collection of fluid, blood, or pus within the vagina, which may extend into the cervix and uterine cavity

In a pediatric patient, this may be secondary to an imperforate hymen

Frequently goes undetected until after menarche, when the collection of menstrual blood trapped in the vagina and/or uterus leads to lower abdominal pain and mass

  • Patient will also have primary amenorrhea
  • May also be seen in older women undergoing radiation therapy

Specific types (combine these locations and types):

  • Hemato= blood
  • Pyo= pus
  • Hydro= watery serous fluid
  • Metro=uterus
  • colpos= vagina

Sono findings

  • Hypoechoic distention of vagina and/or endo cavity
  • Posterior acoustic enhancement
  • Internal echoes may be present and represent debris or clot
  • Hydronephrosis may be present in cases of severe obstruction
  • Attempt should be made to identify possible other genitourinary anomalies
56
Q

Gartner’s duct cyst

A

Occurs on the anterolateral wall of the vagina and arises from the caudal remnants of the mesonephric (Wolffian) duct

57
Q

Vaginal atresia

A

Congenital absence of the vagina

58
Q

Vaginal septa

A

Presence of transverse septations within the vagina

59
Q

Vaginal duplication

A

Presence of two complete vaginas

OBGYN BOARD (4 decks)

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