Path - Uterine Flashcards Preview

Hormonal Reproductive Medicine - Exam II > Path - Uterine > Flashcards

Flashcards in Path - Uterine Deck (16)
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1
Q

what is the most common cause of dysfunctional uterine bleeding?

A

anovulatory cycle

2
Q

what is acute endometritis, what is the common cause and how does it present? how does it histologically differ from chronic endometritis?

A

bacterial infection of endometrium
retained products of contraception
fever, abnormal uterine bleeding, pelvic pain
chronic will have lymphocytes and PLASMA cells

3
Q

what is Asherman Syndrome?

A

secondary amenorrhea due to loss of BASALIS (regenerative layer) and scarring
can be due to overaggressive D&C

4
Q

what drug is associated with endometrial polyps?

A

Tamoxifen - has anti-estrogen effects on breast but weak pro-estrogen effects on endometrium

5
Q

what is endometriosis and how is a diagnosis made? where is the most common site?

A

ectopic endometrial tissue at site outside of uterus
pathologic Dx when 2 of 3 are present in lesion: glands, stroma, hemosiderin
ovary

6
Q

what will ovarian endometriosis look like? what do implants elsewhere look like classically?

A

chocolate cyst

“gun powder” nodules - soft tissue

7
Q

most likely pathogenesis of endometriosis

what does the endometriotic tissue release to promote inflammation?

A

retrograde menstruation - regurgitation of flow into fallopian tube
PGE2

8
Q

what is adenomyosis?

A

endometriosis in myometrium

9
Q

what causes endometrial hyperplasia? what is a common genetic alteration shared between endometrial hyperplasia and carcinoma? what is the most important predictor for progression to carcinoma?

A

unopposed estrogen (obesity, PCOS, ERT)
inactivation of PTEN tumor suppressor gene –> PI3K/AKT pathway becomes overactive
cellular atypia

10
Q

what is the most common invasive carcinoma in female genital tract?

A

endometrial carcinoma

11
Q

two pathways endometrial carcinoma arises, who is affected by each, what are the histological findings?

A
  1. hyperplasia - endometrial hyperplasia; average age is 60; histology is endometrioid (looks like normal endometrium) –> indolent
  2. sporadic - no evident precursor lesion; average age is 70; histology is serous and characterized by papillary structures with psammoma body formation –> more aggressive
12
Q

clinical setting, mutated genes in hyperplasia (type I) vs sporadic (type II) endometrial cancer

A

type I: obesity, HTN, DM (unopposed estrogen); PTEN

type II: thin, atrophy; TP53

13
Q

malignant mixed mullerian tumor

A

endometrial adenocarcinoma with a component of malignant mesenchymal tissue
homologous stroma - resembles normal uterine storma
heterologous stroma - can have sk muscle, cartilage, bone, etc

14
Q

explain the staging of endometrial carcinoma

A

1a - invading < 1/2 myometrium (low grade)
1b - invading > 1/2 myometrium
2 - cervix involvement
3a - tumor involves serosa and/or adnexa
3b - vaginal involvement or parametrial involvement
4 - bladder and/or bowel involvement

15
Q

what is a Leiomyoma (fibroid)? what does it look like grossly? what is the typical presentation? genetic mutation?

A

benign neoplasm of smooth muscle (histo shows cigar shaped nuclei) arising from myometrium - most common tumor in females - PREmenopausal
multiple well defined white whorled masses
ASYMPTOMATIC
70% contain MED12 mutations

16
Q

what is a leiomyosarcoma? from what does it arise? what does gross exam and histo show?

A

malignant proliferation of sm muscle of myometrium
does NOT arise from leiomyoma
POSTmenopausal women
single lesion with hemorrhage and necrosis, histo shows nuclear atypia, mitotic activity, zonal tumor necrosis