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REGUB Path - Uterus (i) (Intro (pathologies affecting uterus (malignancy…
REGUB Path - Uterus (i)
Intro
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epithelium
polyps
non-neoplastic (non-clonal, often just stromal overgrowth)
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stroma: nodule (benign), endometrial stromal sarcoma
muscle: leiomyoma (benign), leiomyosarcoma
mixed: adenomyoma, adenosarcoma, carcinosarcoma
2nd 1/2 of menstrual cycle: endometrial glands more tortuous due to progesterone, then epithelium sheds if no pregnancy
normal glands: well-distributed, spaces between them
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HRT + tamoxifen (oestrogen antagonist in breast, oestrogen partial agents in uterus, a/w swiss cheese polyps): only for a defined period, as oestrogen can encourage uterine neoplasm growth
Endometritis
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chronic: a/w delivery/miscarriage/abortion, IUCD, PID (secondary to STI - chlamydia, mycoplasma, neisseria - screen as can lead to infertility, TB (haematogenous or spread from ovaries)
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Endometriosis
Adenomyosis
type of endometriosis where endometrial tissue is found in myometrium (muscle wall) - cannot shed but tries to - thickening - 'diverticulum'
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locations
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genital tract: ovaries, uterine ligs
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Premalignancy
endometrial hyperplasia
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related to inactivation of PTEN (chromo 10) - tumour suppressor gene, when deleted uterus becomes more sensitive to action of oestrogens
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