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Urogenital System > Pathology of Female Genitalia 2: Corpus Uteri > Flashcards

Pathology of Female Genitalia 2: Corpus Uteri Flashcards

1
Q

List three forms that Abnormal Menstrual Bleeds May present as

A

Menorrhagia
Irregular Periods
Intermenstrual bleeding

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2
Q

What is the most common diagnostic procedure for testing the endometrium

A 
Endometrial bx (biopsy)
Endometrial Curettage
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3
Q

Define Endometriosis

A

Presence of functioning endometrium (glands and stroma) in sites other than the uterine mucosa

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4
Q

Presence of functioning endometrium (glands and stroma) in sites other than the uterine mucosa

A

Endometriosis

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5
Q

What percentage of women are affected by endometriosis

A

5-10%

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6
Q

Endometriosis regresses after what stage of life

A

Menopause

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7
Q

Endometriosis occurs most frequently in which structures of the FGT (female genital tract)

A

Ovaries
Fallopian tubes
Pelvic peritoneum
Umbilicus

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8
Q

List three clinical symptoms/ complications of endometriosis

A

Pelvic pain
Infertility
Ectopic Pregnancy

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9
Q

List three possible aetiologies for Endometriosis

A

Regurgitation (retrograde menstrual flow)
Metaplasia
Vascular Dissemination (of cancer cells)

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10
Q

Define Endometrium Hyperplasia

A

Excessive endometrial proliferation due to prolonged, unopposed hyperoestrogenism

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11
Q

List four causes of unopposed hyperoestrogenism in Endometrium Hyperplasia

A

Persistent failure of ovulation
Polycystic Ovaries (stein - leventhal syndrome)
Therapy with exogenous oestrogens
Oestrogen- secreting ovarian tumours

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12
Q

List the three old classifications of Endometrium Hyperplasia
And the two new

A

Simple Hyperplasia
Complex Hyperplasia
Atypical Hyperplasia

Benign or Nonatypical
Endometrial Intraepithelial Neoplasia EIN

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13
Q

What is the percentage chance that Simple Hyperplasia progresses into endometrial adenocarcinoma

A

1%

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14
Q

What glandular changes are seen in Simple Hyperplasia

A

Glandular and Stromal proliferation

Glands become elongated and cystically dilated

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15
Q

What cause the glandular changes that are seen in Simple Hyperplasia

A

Oestrogen stimulation

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16
Q

Is there cellular Atypia present in Endometrium Simple Hyperplasia

A

Nope

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17
Q

What glandular changes are seen in Endometrium Complex Hyperplasia

A

Marked proliferation of glands -

Crowding, touching, budding and branching

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18
Q

Describe the lining epithelium in Endometrium Complex Hyperplasia

A

Hyperplastic

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19
Q

Is there cellular atypia in Endometrium Complex Hyperplasia

A

No significant

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20
Q

What is the risk of progression of Endometrium Complex Hyperplasia to Endometrial Adenocarcinoma

A

3-10%

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21
Q

Is Cellular Atypia present in Endometrium Atypical Hyperplasia

A

Yes

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22
Q

What is the chance of progression of Endometrium Atypical Hyperplasia to Endometrial Adenocarcinoma

A

20-30%

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23
Q

Define a Benign or Nonatypical Hyperplasia

A

It is equivalent to Hyperplasia without atypia ; low risk for Carcinoma

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24
Q

True of false Endometrial Intraepithelial Neoplasia 1 is equivalent to Atypical Hyperplasia

A

True

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25
Q

What is the commonest invasive cancer of female genital tract in US and most first world countries

A

Endometrial Carcinoma

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26
Q

The commonest incidence of Endometrial Cancer is at which stage of life

A

Postmenopausal (>50-60)

27
Q

What is the origin of Endometrioid type Endometrial Cancer?

A

Glands

28
Q

Type I Endometrial Carcinoma is usually associated with which pre existing condition of the FGT

A

Atypical Hyperplasia/ Endometrial Intraepithelial Neoplasia EIN

29
Q

Which type of Endometrial Carcinoma is considered the serous type

A

Type II

30
Q

Does Type II (serous) Endometrial Carcinoma show association with preexisting Hyperplasia?

A

Nope

31
Q

Type II Endometrial Carcinoma has a mutation of which gene as an early event

A

p53

32
Q 
Which has a worse prognosis 
Type I (endometrioid) or Type II (serous)
A

Type II (serous)

33
Q

Where does Endometrium Carcinoma spread to first

A

Locally to invade the myometrium

34
Q

Metastases of Endometrium Carcinoma occurs via

A

Lymphatics to pelvic and para-aortic nodes

Blood stream to liver, lung and bone

35
Q

When does haematogenous spread of Endometrium Carcinoma occur

A

Late in the course of the disease

36
Q

Which stage of endometrial carcinoma is confined to the corpus uteri

A

Stage I

37
Q

Which stage of Endometrial Carcinoma involves the cervix

A

Stage II

38
Q

Which stage of Endometrial Carcinoma occurs with extrauterine spread but is confined to the pelvis

A

Stage III

39
Q

Which stage of Endometrial Carcinoma occurs with extrapelvic spread with or without involvement of bladder or rectum

A

Stage IV

40
Q

What are the three classifications of Endometrial Sarcoma

A

Endometrial Stromal Sarcoma
Adenosarcoma
Carcinosarcoma ( Malignant Mixed Mullerian Tumour, MMMT)

41
Q

Define an Endometrial Stromal Sarcoma

A

It is composed of malignant stromal cells - round and / or spindly
Infiltrates the myometrium

42
Q

Define Endometrial Adenosarcomas

A

They have a benign glandular component

Have a malignant stroma that may resemble that of endometrial stromal sarcoma or carcinosarcoma

43
Q

What type of Endometrial Sarcoma
They have a benign glandular component
Have a malignant stroma that may resemble that of endometrial stromal sarcoma or carcinosarcoma

A

Adenosarcoma

44
Q

What type of Endometrial Sarcoma
It is composed of malignant stromal cells - round and / or spindly
Infiltrates the myometrium

A

Endometrial Stromal Sarcoma

45
Q

Define Carcinosarcoma (Malignant Mixed Mullerian Tumour)

A

Have a malignant glandular component in addition to the malignant stroma

46
Q

Which type of Endometrial Sarcoma is also called Carcinosarcoma

A

Malignant Mixed Mullerian Tumour

47
Q

Which type of Endometrial Sarcoma is also called Malignant Mixed Mullerian Tumour

A

Carcinosarcoma

48
Q

Sarcoma of the Endometrium affects which age women

A

Elderly

49
Q

Describe Endometrial Sarcoma appearance

A

Large, polyploid mass, usually arising from fundus

Fills Endometrial cavity

Haemorrhagic and necrotic

50
Q

Does Endometrial Sarcoma have a good prognosis

A

Poor

Especially if it spreads outside the uterus

51
Q

Define Adenomyosis

A

Ectopic Endometrial glands and stroma in myometrium

52
Q

List three symptoms of Adenomyosis

A

Abnormal uterine bleeding
Dysmenorrhea
Infertility

53
Q

What are two clinical presentations of Adenomyosis

A

Enlarged uterus

Trabeculated myometrium

54
Q

What is a Leiomyomata of the myometrium

A

Benign smooth muscle tumour of the myometrium

55
Q

Benign smooth muscle tumour of the myometrium

A

Leiomyomata

56
Q

List four symptoms of Leiomyomata

A

Asymptomatic
Dysmenorrhea
Infertility
Compression symptoms: bladder rectum

57
Q

Is malignant change of Leiomyomata rare or common

A

Rare

58
Q

What are the three locations of the uterus you can find a leiyomata

A

Submucosal
Intramural
Subserosal

59
Q

Describe the gross appearance of a fibroid

A

They are circumscribed, lobulated, firm masses of variable size with a white cut surface

Histology ( interlacing bundles of smooth muscle fibers arranged in whorls)

60
Q

Complications of fibroids in pregnant women

A

Inc the frequency of spontaneous abortion
Fetal malpresentation
Postpartum haemorrhage

61
Q

The inactivation of which gene leads to type 1 Endometrial Carcinoma (endometrioid type)

A

PTEN tumour suppressor gene

62
Q

What is the treatment for benign or non-atypical hyperplasia

A

Progestin (to combat unopposed œstrogènes stimulation)
And repeated endometrial curettage

63
Q

What is the treatment for atypical hyperplasia

A

Close follow up, biopsy every 3-6 months

Possible hysterectomy

64
Q

What is the term used to describe the gross appearance of a fibroid when it outgrows its supply ?

A

Red hepatization

Urogenital System (17 decks)

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