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Path: Uterus
keep it simple
| Question | Answer |
|---|---|
| what pathology of the endometrium can present with bleedign | virtually all of them |
| estrogen signals what phase | proliferative |
| progesterone signals what phase | secretory |
| what happens to the stroma during the secretory phase | progesterone prevents it from shedding and it has a pseudodecidualized appearance |
| what does the stroma in post menopausal women look like | dense but thin |
| what do oral contraceptive do to the glands and stroma | glands are small and inactive and the stroma is predecidualized |
| most common cause of abnormal bleeding | anovulation |
| what is the histiological explanation for dysfunctional uterine bleeding | estrogen stimulation without subsequent progesterone to shed the lining |
| Acute endometriosis | often s. aureus, strep or gonorrhea that occurs postpartum or post abortion (remaining placental parts) |
| histology of acute endometriosis | neutrophils in stroma microabscess and filling gland lumens |
| Chronic endometriosis | may be due to infections (chlam or gon) or trauma from IUD or leiomyomata emboli |
| histology of chronic endometriosis | infiltrate of plasma cells not neutrophils like acute |
| endometrial Polyp | common benign may cause irregular bleeding |
| what is an endometrial polyp histiologically | dilated gland with fibrotic stroma and thick walled vessel |
| Adenomyosis | when ENDOMETRIAL gland is found within the MYOMETRIUM |
| Endometrial Hyperplasia | in perimenopausal women as a result of increased estrogen due to proliferation of the glands |
| when is endometrial hyperplasia considered to be premalignant | when there is cellular atypia |
| Endometrial Adenocarcinoma | 4th most frequent cancer in women with excess estrogen being the main association based on obesity, therapy, age of menopause, anovulation, tamoxifen) |
| what percent of patients with adenocarcinoma are postmenopausal | 75% |
| who is the typical adenocarcinoma patient | obese women with chronic anovulation (Polycystic ovarian disease) who is postmenopausal |
| most common type of adenocarcinoma | endometrioid |
| Endometrioid Adenocarcinoma | hyperplasial version of endometrial adenocarcinoma |
| Uterine papillary serous carcinoma | worse prognosis atrophic version of endometrial adenocarcinoma |
| what is the difference in prognosis between endometroid and UPSC (adenocarcinomas of the endometrium) | UPSC has a much worse prog. Endometroid have 90% 5 year with 75% presenting in stage 1 |
| Leiomyomas | benign fibroids MOST COMMON NEOPLASM IN WOMEN (25% of premenopausal) |
| how do leiomyomas appear | whorled tan-white interlaces smooth muscle |
| Leiomyosarcomas | Malignant mets to lung liver and brain within 2 years of diagnosis unlike leiomyomas they have focal hemorrhage necrosis and cytological atypia |
| Malignant Mixed Mullerian Tumor | often in elderly women with polypoid mass coming from the endometrium and protruding through the cervix (poor prog - mix of leiomyosarcoma, rhabdomyosarcoma and osteosarcoma) |
Created by:
jmuame03
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