Female Genital Tract – Uterus & Pregnancy-Related Pathology (Dr. Tasneem M. Elshiekh)

Vocabulary flashcards summarizing key pathological terms and definitions for uterine and pregnancy-related disorders discussed in the lecture.

Endometritis

Inflammation of the endometrium; presents with fever, abdominal pain, abnormal bleeding, infertility or ectopic pregnancy.

Acute Endometritis

Usually caused by Neisseria gonorrhoeae or Chlamydia trachomatis; part of pelvic inflammatory disease or postpartum sepsis.

Chronic Endometritis

Endometrial inflammation diagnosed by the presence of plasma cells; may follow PID, tuberculosis, IUD use or postpartum infection.

Granulomatous Endometritis

Chronic endometritis due to Mycobacterium tuberculosis, seen mainly in immunocompromised patients in TB-endemic areas.

Adenomyosis

Growth of basal endometrium deep into the myometrium; does not undergo cyclic bleeding but causes menorrhagia, dysmenorrhea and enlarged uterus.

Endometriosis

Ectopic endometrial glands/stroma outside the uterus; common cause of cyclical pelvic pain, forms ‘chocolate cysts’ in ovary.

Chocolate Cyst

Blood-filled cyst of the ovary produced by repeated hemorrhage in ovarian endometriosis.

Reverse Menstruation Theory

Proposed mechanism for endometriosis: endometrial tissue refluxes through fallopian tubes into peritoneal cavity during menses.

Dysfunctional Uterine Bleeding (DUB)

Abnormal bleeding without a structural uterine lesion; commonly due to anovulation, inadequate luteal phase or contraceptive effect.

Anovulatory Cycle

Failure to ovulate leading to estrogen excess and irregular, often heavy uterine bleeding.

Inadequate Luteal Phase

Corpus luteum fails to mature → progesterone deficiency and abnormal bleeding.

Endometrial Hyperplasia

Proliferation of endometrial glands caused by unopposed estrogen; precursor to endometrioid carcinoma.

Simple Hyperplasia

Diffuse glandular proliferation without atypia; virtually no cancer risk.

Complex Hyperplasia

Crowded, complex glands without cytologic atypia; moderate cancer risk.

Atypical Hyperplasia

Hyperplasia with cytologic atypia; highest progression risk to carcinoma.

Major Hyperplasia Risk Factors

Unopposed estrogen from anovulation, obesity, estrogen therapy, PCOS, granulosa-theca tumors.

Endometrial Polyp

Sessile hemispheric mass of basalis-type endometrium with thick-walled arteries; causes abnormal bleeding, rarely malignant.

Leiomyoma (Fibroid)

Benign smooth-muscle tumor of myometrium; estrogen-sensitive, common in reproductive-age women, produces menorrhagia and pelvic mass.

Leiomyosarcoma

Malignant smooth-muscle tumor arising de novo; solitary, soft, necrotic, metastasizes to lungs; ~40 % 5-year survival.

Endometrioid Carcinoma

Estrogen-dependent Type I endometrial cancer; arises from hyperplasia, PTEN/DNA mismatch repair mutations; late metastasis.

Serous Endometrial Carcinoma

Type II cancer in atrophic endometrium of older women; early TP53 mutation, aggressive with early spread.

PTEN Gene

Tumor-suppressor gene frequently inactivated early in endometrioid carcinoma development.

TP53 Gene

Tumor-suppressor gene mutated early in serous carcinoma of the endometrium.

Stage (Endometrial Cancer)

Most important prognostic factor; serous tumors usually present at higher stage than endometrioid tumors.

Spontaneous Abortion

Pregnancy loss before 20 weeks gestation; listed under early pregnancy disorders.

Ectopic Pregnancy

Implantation of embryo outside uterine cavity, typically in fallopian tube; early pregnancy complication.

Placenta Accreta

Placental chorionic villi attach directly to myometrium due to absent decidua; causes postpartum hemorrhage.

Accessory Lobe

Additional placental lobe connected by vessels; one of the placental anomalies.

Circumvallate Placenta

Placenta with rolled fetal membranes at the edge; associated with fetal growth restriction.

Villitis

Inflammation of chorionic villi, usually hematogenous (TORCH infections).

Chorionamnionitis

Ascending bacterial infection of fetal membranes; causes maternal fever, preterm labor.

Funisitis

Inflammation of the umbilical cord; often accompanies severe chorionamnionitis.

TORCH Infections

Transplacental pathogens (Toxoplasma, Others, Rubella, CMV, Herpes) causing villitis.

Gestational Trophoblastic Disease

Spectrum of placental trophoblast tumors including hydatidiform moles and choriocarcinoma; produce high hCG.

Hydatidiform Mole

Abnormal chorionic villi with trophoblastic proliferation; complete or partial; elevated hCG; ‘grapelike’ swollen villi.

Complete Mole

46,XX/XY diploid, all villi edematous, no fetal parts; 2 % risk of choriocarcinoma.

Partial Mole

Triploid 69,XXY, some normal villi, fetal tissue present; negligible choriocarcinoma risk.

Invasive Mole

Molar tissue that penetrates myometrium but lacks malignant cytology; can cause uterine rupture.

Choriocarcinoma

Highly malignant trophoblastic tumor arising from pregnancy; rapid hematogenous spread, very high hCG, chemotherapy-curable.

hCG (Human Chorionic Gonadotropin)

Placental hormone markedly elevated in moles and choriocarcinoma; useful diagnostic and follow-up marker.

Menorrhagia

Excessive prolonged menstrual bleeding; common symptom of leiomyoma or adenomyosis.

Metrorrhagia

Irregular, acyclic uterine bleeding between periods.

Pelvic Inflammatory Disease (PID)

Ascending infection of female genital tract; important cause of acute endometritis and infertility.

Post-partum Sepsis

Uterine infection following delivery; can lead to endometritis.

IUD-Associated Endometritis

Chronic endometritis linked to intra-uterine device presence.

Pre-eclampsia/Eclampsia

Toxemia of late pregnancy characterized by hypertension, proteinuria (± seizures); listed among late pregnancy disorders.

Bipartite Placenta

Twin placental anomaly consisting of two equal lobes connected by membranes.

Adenosarcoma (Uterine)

Mixed tumor with benign glands and malignant stromal component; can coexist with endometrial carcinoma.