Pathology of Uterus Flashcards
(51 cards)
What can be used to investigate the uterus?
What is considered abnormal in women?
TV-USS or a hysteroscope
> 4mm in post-menopausal and >16mm in pre-menopausal is generally indication for a biopsy
What is the most common cause for DUB?
anovulatory cycle - this is the lack of development of a leading follicle and corpus luteum. SO there is no lutinising phase and continued oestrogen release - results in continued growth of endometrium
What are some causes of anovulation?
PCOS, hyperprolactinaemia, pituitary failure, hypothalmic dysfunction, thyroid disorders
What is endometritis?
This is inflammation of the endometrium caused by:
- organsims (neisseria, chlamydia, TB, CMV, HSV…)
- IUD
- Post partum/ post abortion/ post currettage
- chronic
- associated with leimyomata or polyps
- granulomatous disease
What protective mechanisms prevent infection in the endometrium?
Cervical mucous plug protects from ascending infection
Cyclical shedding
What is chronic plasmocytic endometritis associated with?
PID - infectious until proven otherwise
How will endometrial polyps present?
Usually asymptomatic (found incidentally) but can present with bleeding
most commonly found on peri- or post-menopausal women
almost always benign
What can present as endometrial polyps?
Endometrial cancer
What is a molar pregnancy?
this is an abnormal fertilised egg that implants into the uterus or tubes
it can be either partial or complete
it is a form of gestational trophoblastic disease
What is molar pregnancy characterised by?
swollen chorionic villi
What is the definition of a ‘complete’ molar pregnancy?
This is when a haploid sperm will fertilise an egg that has lost its DNA. This will then divide to have 46 chromosomes but the DNA will only be paternal
What is the definition of a ‘partial’ molar pregnancy?
This is when 2 sperm or 1 sperm that duplicates will fertilise an egg to give 69XXY (triploidy). both maternal and paternal DNA is pregnant
What can develop from a molar pregnancy?
Choriocarcinoma (malignant tumour of trophoblasts) - complete has a greater risk than partial of developing into this
What will a molar pregnancy look like on USS?
Snow storm appearance
What is adenomyosis?
This is the growth of enometrium (glands and stroma) through the myometrium
What is a leiomyoma?
benign tumour of the smooth muscle (can occur in any location of smooth muscle)
What hormone is a leiomyoma dependent on?
Oestrogen dependent for growth
What is the difference between endometrial polyp and a fibroid?
Polyp = overgrowth of the endometrial layer Fibroid = overgrowth of the myometrium
What are the characteristics of an adenomyosis?
35-40, menorrhagia, dysmenorrhoea, dyspareunia, reduced fertility
How is adenomyosis treated?
Progesterone
What are the characteristics of a leiomyoma?
Also called fibroids
very common in women over 40
Present with pelvic mass, menorrhagia, infertility, compression on the uterine cavity
What is ‘red degradation’?
this is the acute disproportionate pain associated with the newly compromised blood supply to a fibroid. This is most commonly occurring in pregnancy or perimenopause
How will a leiomyoma (fibroid) look on USS?
smooth echogenic mass, usually multiple
What cells are present on a histology slide of a fibroid?
Smooth muscle cells interlacing
