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Pathology of the Reproductive System

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Title: Pathology of the Reproductive System


1
Pathology of the Reproductive System
  • DMI 56
  • Marilyn Rose

2
The Female Reproductive System
  • Uterus and Adnexa
  • Breasts

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3
Imaging of the Female Reproductive System
  • Hysterosalpingogram
  • Pelvic Sonography
  • Mammography

4
Hysterosalpingogram
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5
Pelvic Ultrasound
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ey.org/Images/Radiology/ClickableImages/PelvicUltr
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6
Mammogram
sciencelearn.org.nz
7
Congenital Abnormalities
  • Bicornuate Uterus
  • Paired uterine horns that extend to the uterine
    tubes
  • Unicornuate Uterus
  • The uterine cavity is elongated and has one
    uterine tube
  • Often the kidney on that side is missing
  • Uterus Didelphys
  • Complete duplication of the uterus, cervix, and
    vagina
  • The most serious complication with these
    abnormalities is with reproduction
  • Most can be corrected surgically

8
Didelphic Uterus
there is a double uterus with two separate
cervices, and often a double vagina as well. Each
uterus has a single horn linked to the
ipsilateral fallopian tube that faces its ovary.
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ail_list.php?cat3989
double uterus with two separate cervices, and
often a double vagina as well. Each uterus has a
single horn linked to the ipsilateral fallopian
tube that faces its ovary.
9
Unicornuate Uterus
A unicornuate uterus is a type of congenital
uterine abnormality (müllerian duct abnormality).
A unicornuate uterus is smaller than a typical
uterus and usually has only one functioning
fallopian tube. The other side of the uterus may
have what is called a rudimentary horn.
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.php?offset15cat117cat3313styped
10
Retroverted Uterus
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roverted_uterus_MRI_002.jpg/200px-Retroverted_uter
us_MRI_002.jpg
A retroverted uterus (tilted uterus, tipped
uterus) is a uterus that is tilted backwards
instead of forwards.
11
Inflammatory Diseases
  • PID
  • A bacterial infection
  • Gonococcus, staphylococcus, or streptococcus
    bacterias
  • Unsterile abortion, IUD insertion, or pathogens
    from other sources
  • The inflammationbilateral and spreads to the
    peritoneum
  • Abcesses may form (risk sterility)
  • Sing abdominal and pelvic pain, along with fever
  • Antibiotic therapy is used to treat this disorder
  • Increased risk of ectopic pregnancy

12
Inflammatory Diseases
  • Mastitis
  • Caused by staphylococcus aureus
  • Occurs in the breast of lactating females
  • Bacteria invades through cracks in the skin
    surrounding the nipple
  • Patient will experience pain, redness, swelling
    and fever
  • Antibiotics and heat application are used for
    treatment

13
Neoplastic Diseases
  • Cystadenocarcinoma
  • A malignant neoplasm of the ovary
  • Occurs in women over age 40
  • It is the most lethal with a very poor prognosis
  • The tumors often spread to other pelvic organs
    and the digestive system
  • Treatment includes surgery, radiation and
    chemotherapy

14
Neoplastic Diseases
  • Carcinoma of the uterus
  • One of the most common female cancers
  • More common in nulliparous(?) females
  • Stage 0 is curable by hysterectomy
  • Stage 1 or 2 are usually treated by surgery and
    radiation therapy
  • 5 year survival rate is 80

15
Neoplastic Diseases
  • Breast Carcinoma
  • Second leading cause of female cancer deaths in
    the US
  • The etiology is unknown
  • Early detection increases the chance of survival
  • Mammography is the method of choice for detection
  • Treatment includes surgery, radiation or
    chemotherapy

16
Breast Carcinoma
17
Disorders During Pregnancy
  • Ectopic Pregnancy
  • Development of a fetus outside the uterine cavity
  • The most common site is the uterine tube
  • If the condition remains untreated, the blood
    vessels can rupture as the tissue stretches
  • The treatment is surgical removal of the embryo
    and uterine tube

18
Disorders During Pregnancy
  • Placenta Previa
  • The placenta develops in the lower half of the
    uterus
  • Causes obstruction of the internal cervical os
  • The mother may experience bleeding in the late
    stages of pregnancy
  • Hemorrhage can occur, which can be
    life-threatening for both mother and fetus
  • Ultrasound is helpful in diagnosis
  • Normal delivery cannot occur
  • A cesarean section is normally performed

19
The Male Reproductive System
  • Paired Testicles
  • Prostate gland
  • Imaging is limited to urethrograms, IVU, and CT
  • Sonography is used to evaluate the testicles and
    prostate
  • Ultrasound can differentiate between epididymitis
    and testicular torsion

20
Congenital Anomalies
  • Cryptorchidism
  • A condition of undescended testes
  • The rate of malignancy is much greater with this
    condition
  • Testicles are usually brought down and fixed into
    position
  • Sonography is used to locate the testicle

21
Neoplastic Diseases
  • Prostatic Hyperplasia BPH
  • A common benign enlargement
  • Usually affects men over 50
  • Patients will experience difficulty with
    urination
  • Patients may be treated with a TURP
  • Hyperplastic changes are easily visualized on CT
    and sonography
  • Prostatic calculi can be seen on plain abdominal
    films

22
Benign Prostatic Hypertrophy
23
Neoplastic Diseases
  • Adenocarcinoma of the prostate
  • Affects older males, incidence increases with age
  • The disease is usually diagnosed by physical
    examination
  • Acid phosphatase levels will be elevated
  • Patients may often experience urinary tract
    obstructions
  • Treatment includes surgical excision, hormone
    treatment, or radioactive seeds to prostate
  • Skeletal metastases may occur in about 75 of the
    cases
  • It is the third leading cause of cancer deaths
  • It has a five year survival rate of about 33

24
Carcinoma of the Prostate
25
Neoplastic Diseases
  • Testicular masses
  • Seminomas
  • Arise from the seminiferous tubules
  • Accout for about 40 of testicular tumors
  • These tend to grow rapidly but remain localized
  • These neoplasms are very radiosensitive
  • The prognosis is excellent with radiation therapy
  • 10 year survival rate is about 90
  • Teratomas
  • Composed of different cell types
  • Very poor prognosis
  • Highly malignant
  • Metastasize via lymphatic and hematogenous spread
  • 10 year survival rate is about 50 - 75

26
Inflammatory Diseases
  • Testicular Torsion
  • Results from a testicle twisting upon itself
  • Reduced surgically- can cause severe compromise
    of vascularity (6hours until testicle dies)
  • Ultrasound/Nuclear medicine scans will
    demonstrate decreased uptake on the affected side
  • Scrotal pain and swelling is usually present

27
Inflammatory Diseases
  • Epididymitis
  • Inflammation of the epididymis
  • Also leads to scrotal swelling
  • The increased blood flow can be seen on
    sonography and on nuclear medicine scans
  • The affected side will demonstrate increased
    uptake

28
Inflammatory Diseases
  • Gonorrhea
  • Most common and widespread
  • venereal bacterial infection
  • Symptoms occur within days after infection
  • Men experience acute urethritis with pus
    discharge
  • Women are usually asymptomatic
  • Usually responds to antibiotic therapy
  • If untreated
  • urethral strictures in men
  • pelvic inflammatory disease in women.
  • Fibrous scarring in the fallopian tubes causing
    sterility or increased risk of ectopic pregnancy
    occurs as a serious complication
  • May also cause septic arthritis

29
Urethral Strictures From Gonorrheal Infection
30
Inflammatory Diseases
  • Syphillis
  • Chronic sexually transmitted disease
  • Caused by the spirochete Treponema pallidum
  • Babies can be born with congenital syphillis
  • Chancre sores develop on the genitalia
  • Antiobiotics are successful in treating syphillis
  • Lack of treatment can lead to destruction of bone
  • Osteomyelitis
  • Neuropathic joint disease
  • Mental disorders, deafness, blindness

31
Syphilitic Changes In Bone
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