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Block 2 PATH Exam -- Uterine Corpus Lecture


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Appearance of endometrium on Oral contraceptives
Small, inactive glands
Pre-decidualized stroma (progesterone effect)
Acute Endometritis
Usually result of bacteria (Staph, Strep, N. Gonnorrhoeae)
Usually occurs in postpartum or postabortal period
Fever, chills, pelvic pain
Histology -- focal aggregates of PMNs in stroma and filling gland lumens
Chronic Endometritis
Non-specific, but probably due to infections or trauma
Histology -- infiltrate of PLASMA CELLS and lymphocytes
Endometrial Polyps
Contain cystically dilated glands, fibrotic stroma
THICK-WALLED blood vessels
Endometrial glands and stroma within the myometrium
Endometrial hyperplasia
Most commonly in perimenopausal women
If cytologic atypia is present --> increased risk of cancer
2 types of Endometrial Adenocarcinoma
Endometrioid (most common)
Uterine Papillary Serous Carcinoma (UPSC)
Endometrioid Carcinoma
Excessive estrogen is the main association
75% of patients are POST-menopausal (~63 yo)
75% of patients present with stage I disease (90% 5 yr.)
Potentially curable if detected early enough
Uterine Papillary Serous Carcinoma (UPSC)
Tends to occur in elderly women
Occurs in setting of atrophy, NOT hyperplasia
Tends to present at higher stages
Aggressive, has a poor prognosis
Most common neoplasm in women (~25% pre-menopausal)
BENIGN, but can get extremely large
Gross -- well-circumscribed, spherical, dense, whorled, tan-white
Histology -- interlacing bundles of UNIFORM cells
Rare and malignant
Often metastasize within 2 yrs. of diagnosis (lung, liver, brain)
Gross -- similar to leiomyoma, BUT hemorrhage and necrosis
Histology -- cytologic atypia, mitotic activity, necrosis
Malignant Mixed Mullerian Tumor (MMMT)
Aggressive tumor with a poor prognosis (30% 5-yr.)
Often presents at high stage
Histology -- mix of adenocarcinoma and malignant mesenchymal components

Characteristic presentation:
Elderly woman, polypoid endometrial mass protruding through cervix

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