Uterine pathology

Question 1

Nabothian cyst

Answer 1

Tiny cysts at surface of cervix, 1-4mm, mucous filled though secretion of cervical glands. no symptoms.

ultrasound:
1-4mm,
anechoic, well defined cystic lesion near the endocervical canal. acoustic enhancement.
cervical region will appear large if cysts are large.
Color doppler shows no associated color flow.

Question 2

Cervical polyp

Answer 2

Small, fragile, elongated benign tumor found in the cervix at the surface inside or outside.
ultrasound:
1-2cm
pedunculated well circumscribed mass within the endocervical canal.
hypoechoic or echogenic
stalk attaching to the cervical wall can be identified.
doppler shows a single feeding vessel running along the length of the polyp.

Question 3

Malignant neoplasm carcinoma of the cervix.

Answer 3

Sign and symptoms: early stages no signs or symptoms.
later stages: vaginal bleeding after intercourse, between periods or after menopause.
Watery, bloody vaginal discharge, heavy and have foul odor.
pelvic pain or pain during intercourse.
Ultrasound:
<4cm or >4cm
hypoechoic, heterogenous mass
increase vascularity on color doppler.
invasion into vagina, parametrial invasion, invasion into adjacent organs and hydronephrosis.

Question 4

septate uterus

Answer 4

normal external uterine surface but has two endometrial cavities.
widening of the uterus in t/section. highest in miscarriages.

Question 5

bicornuate uterus

Answer 5

Abnormal, indented external uterine surface with two endometrial cavities. single cavity in lower uterine segment that splits into two horns in the fundal region

Question 6

didelphys uterus

Answer 6

two halves of the uterus remains separate. can be one cervix to one vagina. or duplication of reproductive organs, each uterine cavity has its own separate cervix. can have two vaginas. heavy menstruation bleeding of both endometrium.

Question 7

arcuate uterus

Answer 7

normal external uterine surface with a 1cm or less indentation into the endometrial cavity.

Question 8

Unicornuate uterus

Answer 8

one half of the uterus has developed.
one uterine horn.

Question 9

endometriosis

Answer 9

problem in women of childbearing age when the endometrial cells normally found inside the uterus, grow outside of the uterine cavity and its muscles. escapes during menstruation the cells escapes and can attach themselves to the ovaries, uterine ligaments and peritoneum. these ectopic cells still respond to hormones and undergo cyclic changes, bleeding during menstruation.

Question 10

symptoms of endometriosis

Answer 10

chronic pelvic pain
sever crampy pain called dysmenorrhea
pain during sexual intercourse,
retroverted uterus,
cause infertility in 30-50% of women.

Question 11

treatment for endometriosis

Answer 11

hormonal methods, pregnancy, birth control pills to suppress ovulation.
cauterization of plagues by laparoscopy.
surgical removal of adhesions
hysterectomy in sever cases.

Question 12

ultrasound of endometriomas

Answer 12

“chocolate cyst”
anechoic/hypoechoic homogenous
unilocular or multilocular contain thin or thick ceptations. color doppler show no internal vascularity.

Question 13

Follicular cyst

Answer 13

when the follicle does not break open to release the egg and continues growing. no symptoms reach up to 4cm.
ultrasound:
thin walled and unilocular
posterior acoustic enhancement
absence of internal echoes
no color flow, nodules or ant solid components.
range between 3-8cm
if smaller than 3cm = ovarian follicle.

Question 14

corpus luteum cyst

Answer 14

thick walled cyst with characteristic of “wall of fire” peripheral vascularity. crenulated inner margin and internal echoes. grow up to 10cm.

Question 15

theca lutein cyst

Answer 15

forms in high levels of beta HCG. secondary to underlying disorder. very high association with gestational trophoblastic disease.
ultrasound:
bilateral enlarged
multi cystic ovaries
thin walled and clear contents.
large amount of solid component which possibly the residual ovarian stroma.

Question 16

malignant

Answer 16

Absence of the crescent sign (normal ovarian tissue around/ adjacent tot the adnexal mass). the larger the tumor the higher the chance of malignancy. a simple cyst <4cm is small.
irregular solid tumor.
ascites
at least four papillary structures
irregular multicolor tumor with largest diameter at 10cm.
high color content on color doppler examination.

Question 17

benign

Answer 17

unilocular, smooth multilocular tumor, solid components where the largest is <7mm in largest diameter. ovarian crescent sign, acoustic shadows, no detectable blood flow or peripheral flow on doppler.