This document discusses endometrial polyps, hyperplasia, and carcinoma. It notes that polyps are benign overgrowths that can cause bleeding. Hyperplasia is excessive growth due to estrogen excess and is classified based on gland crowding and presence of atypia. Endometrial carcinoma is the most common cancer of the female genital tract, arising due to estrogen excess or atrophy. The document describes the risk factors, pathogenesis, morphology, and clinical course of endometrial carcinoma.
This document discusses endometrial polyps, hyperplasia, and carcinoma. It notes that polyps are benign overgrowths that can cause bleeding. Hyperplasia is excessive growth due to estrogen excess and is classified based on gland crowding and presence of atypia. Endometrial carcinoma is the most common cancer of the female genital tract, arising due to estrogen excess or atrophy. The document describes the risk factors, pathogenesis, morphology, and clinical course of endometrial carcinoma.
This document discusses endometrial polyps, hyperplasia, and carcinoma. It notes that polyps are benign overgrowths that can cause bleeding. Hyperplasia is excessive growth due to estrogen excess and is classified based on gland crowding and presence of atypia. Endometrial carcinoma is the most common cancer of the female genital tract, arising due to estrogen excess or atrophy. The document describes the risk factors, pathogenesis, morphology, and clinical course of endometrial carcinoma.
hyperplasia, carcinoma Dr: Salah Ahmed Endometrial polyps
- are focal benign overgrowth of endometrium
- most common located on the fundus - may protrude into vagina and may cause bleeding Endometrial polyp ( fibrous stroma harboring dilated glands lined by columnar epithelium Endometrial hyperplasia
- exaggerated endometrial proliferation due to excess of estrogen
- can be preneoplastic - hyperplasia is classified based on crowding of glands and presence of atypia into: 1- simple hyperplasia 2- complex hyperplasia 3- atypical hyperplasia - these changes depend on the level and duration of the estrogen excess - risk factors: (estrogen excess) 1- failure of ovulation (e.g around the menopause) 2- prolonged administration of estrogen 3- estrogen-producing ovarian lesions (polycystic ovaries) 4- cortical stromal hyperplasia 5- granulosa-theca cell tumors of the ovary 6- obesity ( because adipose tissue processes steroid precursors into estrogens) A) Simple hyperplasia - crowding of glands without atypia some of them are dilated (cystic hyperplasia) :Swiss cheese - only 1% of cases progress to adenocarcinoma B) Complex hyperplasia - crowding and branching of glands without cellular atypia - 3% of cases progress to adenocarcinoma C) Atypical hyperplasia - complex hyperplasia with atypia ( hyperchromatic nuclei, mitotic figures ) - commonly progresses to adenocarcinoma - treated may be with Tamoxifen (antiestrogen) or hysterectomy Endometrial carcinoma
- endometrial carcinoma is the most frequent cancer of the female
genital tract Epidemiology and Pathogenesis: - common between the ages of 55 and 65 years - arises in two clinical settings: 1- in perimenopausal women with estrogen excess (endometrioid carcinoma) 2- in older women with endometrial atrophy (serous carcinoma) - Pathogenesis: 1) Endometrioid type: - related to excess of estrogen - the risk factors: 1- nulliparity 2- early menarche or late menopause 3- obesity (increased synthesis of estrogens ) 4- Diabetes Hypertension Infertility: women tend to be nulliparous, often with anovulatory cycles. 5- prolonged estrogen replacement therapy 6- estrogen-secreting ovarian lesions 7- endometrial hyperplasia - genetic abnormality: 1- mutations in DNA mismatch repair gene 2- mutations in PTEN, a tumor suppressor gene 2) Serous type: - is a distinct type - It typically arises in a background of atrophy - sometimes arises in endometrial polyp - nearly all cases have mutations in the p53 tumor suppressor gene Morphology: - Endometrioid carcinomas: - closely resemble normal endometrium - may be exophytic or infiltrative - may infiltrate the myometrium and enter vascular spaces, with metastases to regional lymph nodes - four stages: stage I: confined to the corpus stage II: involvement of the cervix stage III: beyond the uterus but within the true pelvis stage IV: distant metastases or involvement of other viscera - Serous carcinoma: - forms small tufts and papillae rather than the glands - has much greater cytologic atypia - They behave as poorly differentiated cancers and are aggressive Endometrioid carcinoma )C ( Serous carcinoma of the endometrium displaying (A, B) formation of papillae and marked cytologic atypia )D (Immunohistochemical stain for .p53 reveals accumulation of mutant p53 in serous carcinoma Clinical course:- first clinical indication is marked leukorrhea and irregular bleeding - With progression, the uterus becomes enlarged and fixed - metastases to cervix, tubes, ovaries, vagina, broad ligament, regional LN, lungs, liver Thank you
Prothrombin Time and Activated Partial Thromboplastin Time in Pregnant Women Attending Antenatal Clinic at Nnamdi Azikiwe University Teaching Hospital (Nauth), Nnewi, Nigeria - A Cohort Study