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| ==Uterine prolapse== | | ==Uterine prolapse== |
| :''Urogenital prolapse'' redirects here. | | :''Urogenital prolapse'' redirects here. |
| ===General===
| | {{main|Uterine prolapse}} |
| *'''[[Clinical diagnosis]]'''.
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| *A common indication for a total hysterectomy.
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| *Hysterectomy specimen usually comes with some [[vagina]]l mucosa.
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| *Parous women, usually menopausal.<ref name=pmid20607975>{{Cite journal | last1 = Mladenović-Segedi | first1 = L. | last2 = Segedi | first2 = D. | title = [Most important etiologic factors in the development of genital prolapse]. | journal = Srp Arh Celok Lek | volume = 138 | issue = 5-6 | pages = 315-8 | month = | year = | doi = | PMID = 20607975 }}</ref>
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| *Possibly [[obesity]] - studies vary.<ref name=pmid22732579 >{{Cite journal | last1 = Thubert | first1 = T. | last2 = Deffieux | first2 = X. | last3 = Letouzey | first3 = V. | last4 = Hermieu | first4 = JF. | title = [Obesity and urogynecology: a systematic review]. | journal = Prog Urol | volume = 22 | issue = 8 | pages = 445-53 | month = Jul | year = 2012 | doi = 10.1016/j.purol.2012.03.009 | PMID = 22732579 }}</ref>
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| ===Gross===
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| *Long cervix.
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| ===Microscopic===
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| Features:
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| *Uterus: non-specific.
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| *Vaginal mucosa: (focal) keratinization due to rubbing - '''common finding'''.
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| Note:
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| *Benign stromal atypia may be seen.<ref name=pmid10680891>{{Cite journal | last1 = Nucci | first1 = MR. | last2 = Young | first2 = RH. | last3 = Fletcher | first3 = CD. | title = Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma. | journal = Am J Surg Pathol | volume = 24 | issue = 2 | pages = 231-40 | month = Feb | year = 2000 | doi = | PMID = 10680891 }}</ref><ref>{{Cite journal | last1 = Rodrigues | first1 = MI ''et al.'' | last2 = | first2 = | title = Atypical stromal cells as a diagnostic pitfall in lesions of the lower
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| female genital tract and uterus: a review and presentation of some unusual cases | journal = Patología | volume = 47 | issue = 2 | pages = 103-7 | month = April-June | year = 2009 | doi = | PMID = | PMC = | url = http://www.medigraphic.com/pdfs/patrevlat/rlp-2009/rlp092e.pdf }}</ref>
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| ====Images====
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| <gallery>
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| Image: Keratinized cervix -- intermed mag.jpg | Keratinized cervix - intermed. mag. (WC)
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| Image: Keratinized cervix -- high mag.jpg | Keratinized cervix - high mag. (WC)
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| Image: Keratinized cervix -- very high mag.jpg | Keratinized cervix - very high mag. (WC)
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| </gallery>
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| ===Sign out===
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| <pre>
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| UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
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| - UTERINE CERVIX WITH FOCAL KERATINIZATION OTHERWISE WITHIN NORMAL LIMITS.
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| - NONPROLIFERATIVE ENDOMETRIUM.
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| </pre>
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| <pre>
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| UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
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| - UTERINE CERVIX WITH KERATINIZATION, OTHERWISE WITHIN NORMAL LIMITS.
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| - CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
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| - UTERINE SMOOTH MUSCLE AND SEROSA WITHIN NORMAL LIMITS.
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| - NEGATIVE FOR MALIGNANCY.
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| </pre>
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| | |
| ====Denudated exocervix====
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| <pre>
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| UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
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| - UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND EXOCERVICAL DENUDATION,
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| NO EVIDENCE OF DYSPLASIA.
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| - CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
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| - UTERINE CORPUS WITH BENIGN HYALINIZED NODULE.
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| - NEGATIVE FOR MALIGNANCY.
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| COMMENT:
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| Levels were cut on the uterine cervix sections (A1 and A2).
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| </pre>
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| ====Focal ulceration====
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| <pre>
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| - UTERINE CERVIX WITH PARAKERATOSIS, ACANTHOSIS, CHRONIC INFLAMMATION, AND FOCAL
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| ULCERATION ASSOCIATED WITH GRANULATION TISSUE FORMATION.
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| - PARTIALLY CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
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| - UTERINE CORPUS WITH LEIOMYOMA.
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| - NO EVIDENCE OF DYSPLASIA.
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| - NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.
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| </pre>
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| ====With endometrial polyp====
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| <pre>
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| UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
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| - BENIGN ENDOMETRIAL POLYP WITH NONPROLIFERATIVE ENDOMETRIAL GLANDS.
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| - UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND FOCAL EXOCERVICAL DENUDATION,
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| NO EVIDENCE OF DYSPLASIA.
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| - VERY WEAKLY PROLIFERATIVE ENDOMETRIUM, MOSTLY ATROPHIC APPEARING, NEGATIVE FOR
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| ENDOMETRIAL HYPERPLASIA.
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| - UTERINE CORPUS WITHIN NORMAL LIMITS.
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| - NEGATIVE FOR MALIGNANCY.
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| </pre>
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| ==Dysfunctional uterine bleeding== | | ==Dysfunctional uterine bleeding== |
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| - BILATERAL UTERINE TUBES WITHOUT SIGNIFICANT PATHOLOGY. | | - BILATERAL UTERINE TUBES WITHOUT SIGNIFICANT PATHOLOGY. |
| - NEGATIVE FOR MALIGNANCY. | | - NEGATIVE FOR MALIGNANCY. |
| | </pre> |
| | |
| | ==BRCA carrier== |
| | ===General=== |
| | *Prophylatic bilateral salpingo-oophorectomies (BSOs) done in [[BRCA1|BRCA carrier]]s to reduce risk of [[serous carcinoma]].<ref name=pmid27241111>{{Cite journal | last1 = Shaw | first1 = PA. | last2 = Clarke | first2 = BA. | title = Prophylactic Gynecologic Specimens from Hereditary Cancer Carriers. | journal = Surg Pathol Clin | volume = 9 | issue = 2 | pages = 307-28 | month = Jun | year = 2016 | doi = 10.1016/j.path.2016.02.002 | PMID = 27241111 }}</ref> |
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| | Incidence of pathology in prophylatic BSOs in a series of 226 cases:<ref name=pmid22710074>{{Cite journal | last1 = Mingels | first1 = MJ. | last2 = Roelofsen | first2 = T. | last3 = van der Laak | first3 = JA. | last4 = de Hullu | first4 = JA. | last5 = van Ham | first5 = MA. | last6 = Massuger | first6 = LF. | last7 = Bulten | first7 = J. | last8 = Bol | first8 = M. | title = Tubal epithelial lesions in salpingo-oophorectomy specimens of BRCA-mutation carriers and controls. | journal = Gynecol Oncol | volume = 127 | issue = 1 | pages = 88-93 | month = Oct | year = 2012 | doi = 10.1016/j.ygyno.2012.06.015 | PMID = 22710074 }}</ref> |
| | *Invasive carcinoma ~ 0.9%. |
| | *STIC ~ 6.2% |
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| | ===Grossing=== |
| | *In prophylatic procedures, the ovaries and tubes, endometrium, and lower uterine segment should all be [[submitted in total]].<ref name=pmid24495259>{{Cite journal | last1 = Downes | first1 = MR. | last2 = Allo | first2 = G. | last3 = McCluggage | first3 = WG. | last4 = Sy | first4 = K. | last5 = Ferguson | first5 = SE. | last6 = Aronson | first6 = M. | last7 = Pollett | first7 = A. | last8 = Gallinger | first8 = S. | last9 = Bilbily | first9 = E. | title = Review of findings in prophylactic gynaecological specimens in Lynch syndrome with literature review and recommendations for grossing. | journal = Histopathology | volume = 65 | issue = 2 | pages = 228-39 | month = Aug | year = 2014 | doi = 10.1111/his.12386 | PMID = 24495259 }}</ref> |
| | ===Microscopic=== |
| | |
| | DDx: |
| | *Early [[serous carcinoma]] of the fallopian tube or ovary. |
| | *[[STIC]]. |
| | |
| | ===IHC=== |
| | *p53 -ve. |
| | *p16 -ve. |
| | *Ki-67 low. |
| | |
| | ===Sign out=== |
| | <pre> |
| | Uterus, Cervix, Fallopian Tubes and Ovaries, Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy: |
| | - Uterus with fibrous serosal adhesions. |
| | - Cervix within normal limits. |
| | - Atherosclerosis, moderate. |
| | - Inactive endometrium with cystic changes. |
| | - Uterine adenomyosis. |
| | - Fallopian tubes within normal limits. |
| | - Ovaries with benign cysts. |
| | - NEGATIVE for malignancy. |
| </pre> | | </pre> |
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