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59 Cards in this Set
- Front
- Back
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When do gland mitoses occur in the endometrium?
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these indicate proliferation- and they occur during menstruation . Beginning in menses and ending in the secretory phase
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When does the Tortuosity of glands increase?
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these become most tortous in the middle of the secretory phase.
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What does basal vacuolation occur?
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this is the earliest indication of ovulation, and occurs 36-48 hours post ovulation (secretory phase)
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When is stromal edema most common?
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this is most common in the secretory phase, peaking mid secretory phase
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What are the endometrial signs of the proliferative phase?
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rapid growth of glands
straight tubules* mitotic figures* stroma is compacted |
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What are the endometrial signs of the secretory phase?
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glands dilated-> tortuous
spiral arteries* Edema scattered neutrophils/lymphocytes |
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When does acute endometriis occur? TX?
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this occurs due to bacterial infections after delivery/miscarriage
tx- Curretage (scooping out tissue) |
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What are the for situations that can cause chronic endometritis?
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chronic PID
postpartal/postabortal with retained POC IUD's TB |
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What are the hallmark cells for chronic endometritis?
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plasma cells
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What is Adenomyosis?
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this involves the basal layer of endometrial glands growing within the myometrium
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What are the histological features of adenomyosis?
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irregular nests of endometrial stroma w/wo glands 2-3 mm below basalis
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When does adenomyosis produce symptoms?
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hemorrhage with the adenomyosis cyst- is what leads to menorrhagia/dysmenorrhea/dysparenuia
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Where does endometriosis occur?
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ovaries
uterine ligaments rectovaginal septum pelvic peritoneum laparotomy scars can also be in- umbilicus, vagina, vulva, appendix |
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what age groups get endometriosis?
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women in reproductive years, 3rd-4th decade
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What are the three symptoms of endometriosis?
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infertility
dysmenorrhea pelvic pain |
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What are the three explanations for the origin of endometirosis?
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regurgitation
metaplastic vascular/lymphatic spread |
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How are endometriosis foci affected by hormones?
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these undergo cyclic menstrual changes
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What is the gross lesion in the ovary characteristic of endometriosis?
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Chocolate cysts**
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What are the three histological features of endometriosis?
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endometiral glands
stroma hemosiderin pigment |
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How are endometriosis foci affected by hormones?
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these undergo cyclic menstrual changes
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What is the gross lesion in the ovary characteristic of endometriosis?
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Chocolate cysts**
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What are the three histological features of endometriosis?
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endometiral glands
stroma hemosiderin pigment |
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What are the clinical signs and symptoms for endometriosis?
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severe dysmenorrhea
dysparenuia pelvic pain intestinal disturbances menstrual irregularities infertility |
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What may develop at any endometrial site?
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dysfunctional uterine bleeding?
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What drives endometrial hyperplasia?
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estrogen from many sources like
-menopause, PCOD, graunlosa cell tumors, cortical function, ERT |
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What are the two entities of endometrial hyperplasia?
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estrogen field effect of benign endometrial hypeplasia
Endometrial intraepithelial neoplasia |
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What is the most common presentation of endometrial hyperplasia?
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postmenopausal bleeding
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What does endometrial intraepithelial neoplasia need to be treated?
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because this can be come carcinoma
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What tumor suppressor is lost in the EIN scheme of endometrial hyperplasia?
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loss of PTEN expression
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What are the two types of endometrial polyps?
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functional endometrium
hyperplastic endometrium/cystic |
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What is the most common tumor in women?
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Fibroids (a type of leiomyoma)
these arise from smooth muscle cells |
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What is the morphology of fibroids? (leiomyomas)
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sharply circumscribed, discrete, round, firm, gray-white.
can be huge |
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What are the clinical signs of leiomyomas?
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abnormal bleeding
urinary frequency pain impaired fertility |
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do leiomyomas become malignant?
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VERY rare for leiomyomas to become malignant
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What is the most common invasive cancer of the female genital tract?
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endometrial carcinoma
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What age group gets endometrial carcinoma?
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typically postmeopausal women
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What is the presentation of endometrial carcinoma?
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abnormal bleeding
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What is the most common type of endometrial carcinoma?
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Type 1
- well differentiated, mimic's proliferative endometrial glands |
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What are the risk factors for type I endometrial carcinoma?
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obesity
diabetes HTN infertility unopposed estrogen stimulation |
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What gene is mutated in endometrial carcinoma type 1?
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PTEN is mutated here
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How does type I endometrial carcinoma develop?
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prolonged estrogen stimulation and hyperplasia
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What is the morphology of type 1 endometrial carcinoma?
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grossly localized polyploid
direct invasion |
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What age group gets type II endometrial carcinoma?
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older than type 1, about 70yrs old
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What setting does type II endometrial carcinoma arise from?
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endometrial atrophy
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What is the most common subtype of endometrial carcinoma type II?
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serous carcinoma
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What gene is mutated in type II endometrial carcinoma?
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p53 is the most common
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What is the 5 year survival for stage I endometrial carcinoma?
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90%
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What is the 5 year survival for Stage II and III endometrial carcinoma?
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50%
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what is the clinical cours for serous carcinomas (Type II endometrial carcinoma)
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about 50% alive after 3 years
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What is an MMMT?
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this is a malignant mixed mullerian tumor
- endometrial adenocarcinoma with malignant stromal differentiaition - turns into many different malignant mesoderm components |
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What is the prognosis of an MMMT?
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very poor- highly malignant.
5 years survival is abotu 25% |
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What are adenosarcomas composed of?
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large broad based endometrial polypoid growths
stromal neoplasms with benign glands |
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What are the two types of uterus stromal tumors?
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benign stromal nodules
endometrial straom sarcomas |
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What are benign stromal nodules?
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these are well circumscribed aggregates of endometrial stromal cells in the myometrium
-non penetrative this is a type of malignant uterus tumor |
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What are endometrial stromal sarcomas?
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neoplastic endometrial stroma lying between muscle bundles of myometrium
very invasive -type of malignant uterus tumor |
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What do leiomyosarcomas arise from?
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de novo from myometrial/endometrial stroma - which undergoes smooth muscle differentiation
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How do you tell a leiomyosarcoma (bad, malignant) from a Leiomyoma (fibroid)
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leiomyosarcomas have higher mitotic index
more nuclear atypia and zonal necrosis |
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What is the age range for leiomyosarcoma?
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40-60 yrs old
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What is the survival rate of leiomyoarcoma?
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5 year is 40%
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