Kurman, MD Richard W. Hormonal Pathology of the Endometrium L. Hysterectomy with extensive sampling of the endo-metrium can the absence of. Best fellowships after MD Pathology? Ravisingh , Aug 27, Yaah Sep 23, Committee on Gynecologic Practice Society of Gynecologic Oncology This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. The orientation and outline of proliferative phase glands and their relationship to intact stroma are important features for recognizing.
Accessed February 5th, Diagrams Phases Proliferative phase: Early proliferative endometrium Mid proliferative days 8 – Mid proliferative endometrium and Ki67 staining Late proliferative days 11 –
The endometrial cavity is opened to reveal lush fronds of hyperplastic endometrium. Endometrial hyperplasia usually results with conditions of prolonged estrogen excess and can lead to metrorrhagia (uterine bleeding at irregular intervals), menorrhagia (excessive bleeding with menstrual periods), or menometrorrhagia.
Accessed November 20th, Diagrams Phases Proliferative phase: Early proliferative endometrium Mid proliferative days 8 – Mid proliferative endometrium and Ki67 staining Late proliferative days 11 – Day 10 – 12 endometrium shows glands that are more tortuous and crowded; intraglandular nuclear pseudo- stratification and mitotic activity are more prominent see inset and the stroma is edematous and mitotically active Ovulation: Traditionally assumed to be 14 days, but may vary Progesterone secretion inhibits endometrial proliferative activity and induces secretory activity Note:
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Pathology of the EndometriumPathology of the Endometrium Thomas C. Wright Columbia University, New York, NY Changes in the Endometrial cancer Anatomical Regions Corpus: RithResponsive to hormones Thickness changes with outlines. Management of SIL Thomas C. Wright, Jr. Page # 18 Complex Hyperplasia.
Hypercoagulability Factor V Leiden, Prothrombin A mutation, antiphospholipid antibody syndrome Inherited metabolic disorders Fabry disease, homocystinuria, mitochondrial disorders Fibromuscular dysplasia and other angiopathies Severe atherosclerosis Severe atherosclerosis of cerebral arteries. Atherosclerosis and thrombosis Severe atherosclerosis and thrombosis of the basilar artery A large proportion of infarcts are caused by atherosclerosis of large arteries, alone or with superimposed thrombosis.
Atherosclerosis involves the circle of Willis and large leptomeningeal arteries and extends into their smaller branches. The process of lipid accumulation is accompanied by an inflammatory reaction involving lymphocytes and macrophages. Atheromatous plaques may cause narrowing or occlusion of the vascular lumen by themselves or after rupture and thrombosis. Cholesterol crystals from ruptured plaques may embolize distal vessels. Small vessel disease Small vessel disease in a patient with diabetes.
The abnormal vessels are thick and homogeneous.
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Pathology and Clinical Age Age Age Other Liver Future Related Articles This is the most common life-limiting inherited disease. Signsand Useful Related Articles Introudction Endometriosis is a condition in which endometrial, or endometrial like tissue grows outside of the uterus.
Its cyclic structural changes mirror changes in metabolic functions, and both are regulated by ovarian estradiol and progesterone. Because of this interplay of structure, function, and ovarian hormonal stimuli, the endometrium is considered one of the most sensitive indicators of the hypothalamic-pituitary-ovarian hormonal axis. As a result, morphologic evaluation of the endometrium is used in diagnostic evaluation of infertile patients to determine whether ovulation is occurring Fig.
Schematic representation of steroid hormone-morphologic interactions during the endometrial cycle. Estradiol promotes endometrial proliferation, whereas after ovulation, progesterone converts estradiol-primed endometrium into secretory tissue. Postovulatory estradiol amplifies the progesterone effect, and after withdrawal of both estradiol and progesterone, the endometrial mucosa breaks down and regenerates within the period of menstruation.
These steroid receptors are specific proteins concentrated exclusively in the nuclei of both endometrial epithelial and stromal cells, as well as the endothelial cells of stromal capillaries. They have high affinity to bind estradiol and progesterone, respectively. This chapter contains a review of the technical procedures for handling endometrial tissues and a discussion of the morphologic aspects of the endometrium, focusing on the interpretation and understanding of the physiomorphology of the endometrial cycle.
In current practice, the device that is most often used is the Pipelle endometrial aspirator. To ensure a maximum amount of tissue for morphological reading, the specimen should be placed on a piece of lens paper or some other adhesive tissue and then immersed in the fixative. By this means, all of the tissue fragments remain tightly attached to the lens paper, rather than floating in the fixative, and no tissue will be lost for histologic examination.
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Part of the Clinical Perspectives in Obstetrics and Gynecology book series CPOG Abstract The uterus serves the function of providing the developing fetus with a relatively safe and nutritive environment in which to mature. It shows considerable variation in gross and microscopic appearance from neonate to adulthood to senescence. This is a preview of subscription content, log in to check access Preview Unable to display preview.
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Product of conception Villi Decidua 25 Post-menopausal cystic atrophy: Swiss-cheese endometrium mimics simple hyperplasia: Swiss-cheese endometrium mimics simple hyperplasia 26 Aglandular endometrium: Submucosal leiomyoma 27 Common artifacts: Accurate dating not possible Contaminants: Common artifacts Telescoping artifact Artifactual compression 29 Artifacts can be misleading and thus repeat biopsy will be justified if proper evaluation ofendometrium is hampered. Artifacts can be misleading and thus repeat biopsy will be justified if proper evaluation ofendometrium is hampered.
Perforation Uterine perforation Lipoleiomyoma 31 Endometrial metaplasias: Endometrial metaplasias Epithelial Mullerian: Endometrial metaplasias Endometritis with squamous metaplasia Icthyosis uteri 33 Papillary syncytial metaplasia mimicking Serous carcinoma or EIC: Endometrial polyp Endometrial polyp EIN in Endometrial polyp 38 Polyp if not appreciated by gynecologist or radiologist: Polyp if not appreciated by gynecologist or radiologist:
Definitions[ edit ] Surgery is a technology consisting of a physical intervention on tissues. As a general rule, a procedure is considered surgical when it involves cutting of a patient’s tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy , may be considered surgery if they involve “common” surgical procedure or settings, such as use of a sterile environment, anesthesia , antiseptic conditions, typical surgical instruments , and suturing or stapling.
All forms of surgery are considered invasive procedures; so-called “noninvasive surgery” usually refers to an excision that does not penetrate the structure being excised e.
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Hyperplasia and Other Benign Breast Conditions Benign breast conditions also known as benign breast diseases are non-cancerous breast disorders. Some of these conditions increase the risk of breast cancer and others do not. To assess breast cancer risk, benign breast conditions are classified as: Proliferative those with quickly growing cells Non-proliferative those without quickly growing cells Proliferative breast conditions Proliferative breast conditions are not cancerous, but they do increase the risk of breast cancer [ ].
The most common type of proliferative breast condition is hyperplasia. There are 2 types of hyperplasia: Usual hyperplasia In usual hyperplasia the most common form of hyperplasia the proliferating dividing cells look normal under a microscope. Women with usual hyperplasia have about twice the breast cancer risk of women without a proliferative breast condition [ ].