Pathology - Uterus (Myometrium and Endometrium) Flashcards
(41 cards)
What is acute endometritis?
Bacterial infection of the endometrium
- Usually from retained products of conception
What does acute endometritis present with?
- Fever
- Abnormal uterine bleeding
- Pelvic pain
What needs to be seen on histology to diagnose chronic endometritis?
Plasma cells
What are other causes of endometritis?
- IUD
- TB
- Chronic PID (e.g STI)
What does chronic endomtritis present with?
- Abnormal uterine bleeding
- Pelvic pain
- Infertility
What will chornic endometritis show on histology?
Plasma cells
What are the 2 layers of the endometrium?
- Functionalis layer (shedded) (outer layer)
- Basalis (regenerative) layer - regenerates functionalis
What is asherman syndrome?
Secondary amenorrhea due to loss of basalis (regenerative) layer and scarring
What can ashermans be due to?
- Overaggressive dilation and curettage (removal of tissue often for diagnosis or as treatment) or abortion
Where are the stem cells of the endometrium located?
Basalis layer
What is Adenomyosis due to?
Extension of endometrial tissue (glandular) into uterine myometrium
- Caused by hyperplasia of endometrium
What does Adenomyosis show / present with?
- Dysmenorrhea, heavy uterine bleeding and abnormal uterine bleeding
- Uniformly enlarged, soft, globular uterus
How is adenomyosis treated?
- GnRH agonists
- Hysterectomy
- Excision of adenomyoma
Describe the levels of estrogen and progesterone in an anovulatory cycle?
- Estrogen-driven proliferative phase
- No Progesterone-driven secretory phase
What is an endometrial polyp?
- Hyperplastic protrusion of endometrium
- Presents as abnormal uterine bleeding
What disease is associated with tamoxifen use?
Endometrial polyp (ant-estrogenic on breat, pro on endometrium)
What is endometriosis?
Endometrial glands and stroma outside the uterine endometrial lining
What does endometriosis present with?
- Dysmennorhea
- cyclic pelvic pain
What are the different theories behind endometriosis?
- Retrograde menstruation theory
- Metaplastic theory - metaplasia
- Lymphatic dissemination theory
What areas may be involved in endometriosis?
- Ovary (chocolate cysts)
- Uterine ligaments - pelvic pain
- Pouch of Douglas - Pain w. defecation
- Bladder wall - pain with urination
- Bowel serosa - abdo pain and adhesions
- Fallopian tube mucosa - scarring
How may endometriosis be treated/
- NSAIDs
- OCP
- Progestins
- GnRH agonists
- Danazol
- Laparoscopic removal
What does endometriosis involving soft-tissues look like/
Brown specs - “gun-powder” lesions
What is there an increased risk of in people with endometriosis/
Carcinoma at sight of endometriosis (especially ovary)
What is endometrial hyperplasia?
Hyperplasia of endometrial glands relative to storma
- Consequence of unopposed estrogen
