Benign Uterus, Cervix, and Vaginal Pathology Charts PDF

Benign Uterus,Cervix,Vaginal and Endometrial Pathologies Pathology Charts  Benign Vaginal pathology Pathology S&S US Etiology Treatment characteristi cs Gartner’s duct Asymptomati Sim...

Benign Uterus,Cervix,Vaginal and Endometrial Pathologies Pathology Charts  Benign Vaginal pathology Pathology S&S US Etiology Treatment characteristi cs Gartner’s duct Asymptomati Simple cyst They No RX cyst c Well defined represent Incidental STAR embryologic finding remnants of Occur in 25 the caudal % adult end of the women mesonephric (Wolffian) duct https://medcraveonline.com/JACCOA/images/ JACCOA-07-00259-g001.png Imperforate Hymen Pathology S&S US Etiology Differential RX Characteris s tics Imperforated Pelvic pain Hypoechoic Rare 1:2000 Submucosal Surgical Hymen Amenorrhea midline mass females fibroid Intervention Pelvic mass Posterior congenital Endometriom hymenectom on exam enhancemen a y Urinary t Retained POC retention Minimal/lack of myometrial tissue surrounding https://pediatrics.aappublications.org/content/ 142/1_MeetingAbstract/479 Cervical Stenosis Pathology Signs & US Etiology Differentials Treatment Symptoms Characteristi cs Cervical Hypomenorrhe Distention CX, Ablation, prior Endometrial CA Surgery stenosis a Uterus surgery CX CA Amenorrhea Hematometroc Pain olpos https://casereports.bmj.com/content/2016/bcr-2016-217161 Cervical Polyp Pathology Signs & Etiology US Treatment Differential Symptoms characteristic Dx s Polyp Intermenstrual Overgrowth Echogenic Forceps Leiomyoma bleeding endometrial or lesion within removal Cervical cancer endocervical the endocx tissue canal, Better Perimenapausa seen with EV, l women (50’s) and if fluid 25% occur with CD helpful! endopolyp Identify stalk https://radiopaedia.org/articles/cervical-polyp?lang=us Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 36734 https://screening.iarc.fr/atlascolpodetail.php? Index=37&e=,0,1,2,3,8,10,15,19,30,31,43,46,47,60,61,68,73,83,88,89,93,96,102, nabothian cyst Pathology Etiology Signs & US Treatment DDX Symptoms Characteristi cs Nabothian cyst Mucus filled Palp lump STAR , multiple None unless Arcuate vessel cyst on the or solitary large Retained POC cervix < 2.0cm drain Leiomyoma May have percutaneous internal echo’s Spontaneous Posterior resolve enhancement https://radiologykey.com/uterus-2/ https://en.wikipedia.org/wiki/Nabothian_cyst Leiomyoma aka “Fibroids” pathology S&S Risk US Differentials RX factors/caus characteristi es cs Leiomyoma Assymptomatic Family Well defined Ovarian Uterine fibroid Menorrhagia history mass, neoplasm embolization Enlarged African anechoic- Leiomyosarco Myomectomy uterus American hyperechoic, ma Hysterectomy Irregular infertility multiple, bleeding diffuse,ca+, Urinary frequency Infertility Types of Leiomyoma's Type/location S&S location US Diff characteristics Intramural Enlarged uterus Myometrium Multiple, discrete, adenomyosis On exam Most common diffuse Submucosal Bleeding, pain Distorts Impinges on the Polyp endometrium endometrium, or Retained POC is within the cavity Subserosal Large on exam Under the serosa Large discrete Ovarian mass Pedunculated: Large, can cause Broad ligament Adnexa/cul de sac Ovarian mass pain by torsion Vascular pedicle Risk of torsion Parasitic: Large Adnexa, cul de Attached to other Ovarian mass separate from sac organs by vessels Difficult to detect uterus fundul s://radiopaedia.org/articles/uterine-leiomyoma?lang=us  Uterine Fibroids https://www.glowm.com/section_view/heading/Leiomyomas%20of%20the%20Uterus/item/7 https://radiologykey.com/myometrium / https://www.semanticscholar.org/paper/Ultrasound-of-the-gravid-uterus.-Coldwell-Steinkeler/ https://www.drseckin.com/fibroids a569496fac581ded38920d95fd31b04991283466/figure/0 Adenomyosis “ Endometriosis of the Myometrium” pathology S&S Risk US Differentials RX factors/cause characteristi s cs Adenomyosis Pain menses Ectopic Diffuse uterine Degenerating hysterectomy endometrial enlargement fibroid tissue in the Poorly defined Endometrial myometrium, areas within neoplasm multipartity, the elevated myometrium estrogen, Posterior wall aggressive most often curettage affected. Endometrium is normal Myometrial cysts, Venetian blinds https://emedicine.medscape.com/article/405260-overvie Arteriovenous Malformation “AVM” pathology S&S Risk US Differentials RX factors/cause characteristic s s AVM Profuse Instrumentatio Complex mass POC Cautery bleeding n Myometrium Life threatening Congenital Doppler ++ Ore, R. (2015). MILITARY MEDICINE,180, 1:e177, 2015Uterine Arteriovenous Malformation, Images, and Management. MILITARY MEDICINE,180, 1:e177, 2015Uterine Arteriovenous Malformation, Images, and ManagementMaj Robert M. Ore, USAF MC*; 180, 177. Endometrial fluid “ Endometrial infection” Pathology US characteristics S&S Rx Endometritis Thickened endometrial Fever, increased WBC Antibiotics (PID) walls, fluid Pain Doppler + Discharge Catherine Rule, Linda Ashley and Colleen Bergin, Sonographic findings in acute puerperal endometritis, Australasian Journal of Ultrasound in Medicine, 21, 4, (234-240), (2018).Wiley Online Cervical Stenosis Pathology US S&S Rx etiology characteristics Cervical Distended Pain, amenorrhea Surgical Prior surgery or obstruction cx/uterus intervention procedures Low level echo’s https://www.researchgate.net/figure/Cervical- stenosis-and-uterine-atrophy-in-a-37-year-old- woman-with-pelvic-pain-after_fig29_235906581 Post Ablation Failure: Endometrial Regeneration Pathology US S&S Rx characteristics Post ablation Fluid/ debris Pain, cramping Surgical regeneration intervention Wortman, M. (2017). Late-onset endometrial ablation failure. Case Reports in Women's Health, 15(July ), 11–28. doi: https://doi.org/10.1016/j.crwh.2017.07.001  Submucosal Fibroid Pathology S&S US RX Diff Submucosal fibroid DUB, pain Round, hypoechoic D&C Polyp, CA Yang, T. (2013). Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology. World Journal of Radiography, March(28), 81–87. doi: http://dx.doi.org/10.4329/wjr.v5.i3.81 https://www.wjgnet.com/1949-8470/full/v5/i3/81.htm Endometrial Hyperplasia “Excessive growth of the endometrium” Caused by S&S US Differentials RX characteristics endometrium Increased Dysfunctional Prominent Endometrial Cancer D &C unopposed uterine bleeding * Thickened Endometrial polyp Medical D & C estrogen, Assyptomatic** endometrium in pre/post (>14mm/, >8mm Tomoxifen * With or without cysts Diabetes *,** No flow Obestity *.** PCOD Amenorrhea ** https://forum.facmedicine.com/threads/this- gynecological-issue-is-misdiagnosed-over-50- percent-of-the-time.29417/ Asherman’s syndrome “scarred or removed endometrium” Pathology S&S etiology US RX Diff Asherman’s Dysmenorrhe Surgical Thin, Removal of Atrophy a procedures synechaie scar tissue Scar tissue Amenorrhea Infection (adhesiolysis endometrial Infertility Prolonged ) surfaces Recurrent IUCD use Antibiotics Miscarriage Hormonal therapy https://www.sciencedirect.com/science/article/pii/ S0015028208003634  Endometrial polyps “Skin Tag” Causes S &S US Differentials Treatments characteristics Overgrowth of Assymptomatic Focal areas of Endometrial Hysteroscopy endometrial Abnormal bleeding echogenic cancer removal tissue Infertilitiy endometrial Endometrial Unresponsive thickening hyperplasia to progesterone Round/ovoid Submucosal lesion fibroid May contain cystic areas CD shows + vascular stalk https://www.volusonclub.net/empowered-womens- health/sis-with-3d-ultrasound-the-new-gold- standard-for-diagnosing-endometrial-polyps/  Estrogen Antagonists “Tomoxifen” Pathology S&S US RX Diff Tomoxifen Spotting Complex D&C CA, polyp https://www.google.com/search?q=ultrasound+tamoxifen+endometrium&client=firefox-b-1- d&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjsqJLBl5zlAhVhTt8KHUVdDpUQ_AUIESgB&biw=1284&bih=839#imgdii =gs6uHyWEAZkJzM:&imgrc=AOZNEbHJVdWo6M: References Ore, R. (2015). MILITARY MEDICINE,180, 1:e177, 2015Uterine Arteriovenous Malformation, Images, and Management. MILITARY MEDICINE,180, 1:e177, 2015Uterine Arteriovenous Malformation, Images, and ManagementMaj Robert M. Ore, USAF MC*; 180, 177. Catherine Rule, Linda Ashley and Colleen Bergin, Sonographic findings in acute puerperal endometritis, Australasian Journal of Ultrasound in Medicine, 21, 4, (234-240), (2018).Wiley Online Library Wortman, M. (2017). Late-onset endometrial ablation failure. Case Reports in Women's Health, 15(July ), 11–28. doi: https://doi.org/10.1016/j.crwh.2017.07.001 Yang, T. (2013). Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology. World Journal of Radiography, March(28), 81–87. doi: http://dx.doi.org/10.4329/wjr.v5.i3.81