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39 Cards in this Set

  • Front
  • Back
Segments of uterus
cerix; lower uterine segment; body (corpus)
Embryonic origin of body of uterus
fusion of mullerian ducts in sixth week
excessive menstrual bleeding
Menorrhagia bleeding between menses Metrorrhagia
too much bleeding & bleeding between menses
cause of abnormal uterine bleeding in prepubertal
precociaius puberty (hypothalamus, pituitary, ovarian origin)
cause of abnormal uternine bleeding in adolescence
anovulatory cycle
abnormal uterine bleeding in reproductive age
complication of pregnancy; anovulatory cycle; luteal phase defect; anatomic lesions (polyps; chronic endometritis; adenomyosis; leiomyoma; hyperplasia; carcinoma – uncommon)
abnormal uterine bleeding perimenopausal
anovulatory cycle; irregular shedding; anatomic lesions (hyperplasia, carcinoma, polyps)
abnormal uterine bleeding in postemenopause
atrophy; anatomic lesions (hyperplasia; carcinoma; polyps)
dysfunctional uterine bleeding
functional /hormonal disorders causing abnormal uterine bleeding, particularly in reproductive and perimenopausal. Non neoplastic or pre neoplastic
most common cause of dysfunctional uterine bleeding
anovulatory cycle
pathogenesis excess bleeding from anovulatory cycle
in absence of ovulation no corpus luteum and endometrium subject to ‘unopposed’ estrogen and no development of secretory pattern
luteal phase defect
deficient ovarian corpus luteum function; low progesterone; often abnormal bleeding and infertility; delayed endometrium post ovulatory chronological state
bacterial infection of endometrium
acute endometritis
uncommon, associated with retained degenerating tissue after miscarriage or delivery; polymicrobial; may progress to PID (puerperal fever; semmelweiss, etc)
Chronic endometritis
usually associated with pelvic inflammatory disease, also affecting fallopian tubes and ovaries; Chlamydia common agent. Also associated with retained gestation tissues; or intrauterine contraception
Signs and symptoms of chronic endometritis
abnormal bleeding; pain; discharge; infertility; biopsy shows abnormal proliferative phase pattern; PLASMA CELLS and other chronic inflammation
Anatomic non neoplastic lesions of uterus
endometritis; polyps; adenomyosis
endometrial polyps
occur in middle aged and older women; non neoplastic overgrowths of endometrium; usually posterior wall; can cause abnormal bleeding; estrogen responsive; can be seen w/ tamoxifen therapy; adenocarcinoma may arise within polyp
presence of endometrial glands and stroma within myometrium
Gross features adenomyosis
diffuse enlargement of uterus; +/- extreme thickening of myometrium; cystic spaces possible
Microscopic features adenomyosis
endometrial glands and or stroma in myometrium; separate from true endometrial basalis by 2-3 mm
Epidemiology adenomyosis
perimenopausal womaen; seen in 15% surg path uteri; less likely symptomatic than endometriosis; pain and abnormal bleeding
Endometrial hyperplasia
increased gland to stromal ration; too many glands
Epidemiology/etiology of endometrial hyperplasia
related to prolonged exposure to estrogen in absence of progesterone (unopposed estrogen); most commonly in perimenopausal women; women with increased estrogen
Classification of endometrial hyperplasia
based on architecture of glands (simple vs complex); cytological features of epithelia cells (no atypia vs atypia)
appearance of endometrial hyperplasia with simple architecture
glands with tubular configuration and circular outlines, similar to normal endometrium
endometrial hyperplasia with cytologic atypia appearance
nuclear stratification with loss of nuclear polarity, increase in nucleus to cytoplasm, hyperchromasia, prominent nucleoi, increased mitotic figures
precursor to endometroid adenocarcinoma, 23%
atypical endometrial hyperplasia
histological spectrum of complex atypical hyperplasia to what
low grade endometroid adenocarcinoma, hinges on presence or absence of stromal invasion, which may be subtle
endometrial adenocarcinoma risk factors, age
peri and post menopausal, obesity, diabetes, hypertension, inifertility, decreased w/ smoking, wtf
endometrioid adenocarcinoma pathogenesis
increased estrogen, obesity, anovulation, PCOD, hormonally active tumors, tamoxife therapyu
gross appearance endometrioid adenocarcinoma
localized polypoioid masses or diffuse lesions replacing endometrial surface
histo appearance endometrioid adenocarnicoma
glands lined by stratified columnar cytologically malignant cells that invade endometrial stroma. glands contain central areas of squamous metaplasia, spread by invading myometrium and extending into the pelvis, late lymphovascular dissemination
serous adenoacarcinoma of uterus
less common type of adenocarcinom a (vis a vis endometrioid) occurs in elderyly, not assoc with hyper estrogen, p53 mutasions, high grade, nasty
Malignant mixed mullerian tumor
highly aggressive, malignant epithelial and mesenchymal elements, aka carcinosarcoma, differentiation toward elements found in uterus or other elements (heterologous)
malignant mixed mullerian tumor age, presentation
elderly patients, postmenopausal bleeding, mass originating from uterine funddus
endometrial stromal tumor types
stromal nodule and endometrial stromalsarcoma
Types of molar pregnancy
complete mole; fertilization of empty egg; partial mole from fertilization of normal egg by two sperm