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Pathology - Coggle Diagram

- - - - Risk factors
        
        High-risk HPV, smoking and immunodeficiency
      - Squamous cell carcinoma > adenocarcinoma in commonality
      - Complication is hydronephrosis and postrenal failure
      - Pap smear
        
        hyperchromatic nuclei, high nuclear to cytoplasmic ratio
        
        Followed by colposcopy and biopsy
      - Limitations include inadequate sampllng of cervix and limited efficacy with adenocarcinoma
      - Postcoital bleeding, vaginal bleeding and cervical discharge
      - Common in middle aged women
    - - koilocytic change, disordered cellular maturation, nuclear atypia, and increased mitotic activity within the cervical epithelium.
      - Progresses in stepwise fasion
      - Higher grade of dysplasia = more likely it will progress to carcinoma
  - - - Granulosa cells stimulated by FSH which converts androgen to estradiol which drives proliferative phase of endometrial cycle
        
        Estradiol surge leads to LH surge
    - - Drives secretory phase
        
        Hemorrhage into corpus luteum can lead to hemorrhagic luteal cyst
    - - Hormone imbalance LH:FSH
        
        Increased LH induces inc. androgen production which leads to hirsutism
        
        Androgen converted to estrone in adipose tissue
        
        Feedback leads to decreased FSH and results in cystic degeneration of follicle
    - - Cystadenoma
        
        In premenopausal women 30-40
        
        single cyst with simple flat lining
      - Cystadenocarcinoma
        
        Post menopausal women 60-70
        
        Complex cysts with thick shaggy lining
      - BRCA1 mutation carriers increase risk for serous carcinoma of ovary and fallopian tube
    - - Serous are most common
        
        About 70% are benign or borderline
        
        Most common between ages 20 and 45
        
        Carcinomas occur later
      - Sex cord-stromal tumors
        
        Fibromas and thecomas
        
        Solid, spherical, slightly lobulated, encapsulated, hard, gray-white masses covered by ovarian serosa
        
        Consist of well-differentiated fibroblasts with interspersed collagenous stroma
        
        Pain, ascites hydrothorax/pleural effusion, Meigs syndrome
        
        Sertoli leydig tumors
        
        Masculinization and defeminizing effects
        
        Leydig cells contain characteristic Reinke crystals
        
        Granulosa cell tumors
        
        Most common in postmenopausal women
        
        Hormonally active
        
        Have yellow coloration due to IC lipids
        
        Small cuboidal to polygonal
        
        Precocious puberty in young girls, proliferative breast disease, endometrial hyperplasia and carcinoma, heavy menstrual bleeding or bleeding outside of cycle in women
        
        Can ocassionally produce androgens masculinizing patient
        
        Causes little or no pain
        
        Elevated inhibin
        
        FOXL2 gene
  - - - Loss of basalis
        
        Secondary amenorrhea
      - Cause
        
        Result of D&C, scraping of uterus and dilate cervix
    - - Results due to estrogen without the progesterone phase
      - Seen during menopause or menarche
    - - Acute
        
        Infection due to retained products of conception
        
        Fever, abnormal uterine bleeding and pelvic pain
      - Chronic
        
        Characterized by plasma cells
        
        Causes include, chronic PID, IUD and TB
        
        Abnormal uterine pain, infertility and pelvic pain
    - - Presents as abnormal uterine bleeding
      - Can arise due to tamoxifen
        
        Has weak pro-inflammatory effects on endometrium
    - - Glands and stroma outside uterine endometrial lining
      - Dysmenorrhea and pelvic pains
        
        Can cause infertility
        
        Adenomyosis - endometriosis that involves myometrium
      - Sites of involvement
        
        Uterine ligamenta - pelvic pain, Pouch of douglas - pain with defecation, Bladder wall - pain with urination, bowel serosa - abdominal pain and adhesions, fallopian tube mucosa - scarring, ovary - chocolate cyst
      - Increased risk of carcinoma esp. at the site of ovary
    - - Hyperplasia of glands relative to stroma
      - Unopposed estrogen, presents as postmenopausal uterine bleeding