Block 2 PATH Exam -- Uterine Corpus Lecture
Terms
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- Appearance of endometrium on Oral contraceptives
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Small, inactive glands
Pre-decidualized stroma (progesterone effect) - Acute Endometritis
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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
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Non-specific, but probably due to infections or trauma
Histology -- infiltrate of PLASMA CELLS and lymphocytes - Endometrial Polyps
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BENIGN
Contain cystically dilated glands, fibrotic stroma
THICK-WALLED blood vessels - Adenomyosis
- Endometrial glands and stroma within the myometrium
- Endometrial hyperplasia
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Most commonly in perimenopausal women
If cytologic atypia is present --> increased risk of cancer - 2 types of Endometrial Adenocarcinoma
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Endometrioid (most common)
Uterine Papillary Serous Carcinoma (UPSC) - Endometrioid Carcinoma
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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)
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Tends to occur in elderly women
Occurs in setting of atrophy, NOT hyperplasia
Tends to present at higher stages
Aggressive, has a poor prognosis - Leiomyoma
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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 - Leiomyosarcoma
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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)
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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