Difference between revisions of "Uterine prolapse"

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Comment:
Comment:
The stromal atypia is favoured to be benign change, as it is without significant proliferation and
The stromal atypia is favoured to be benign change, as it is without significant proliferation,
not mass forming.  
not mass forming and near the stromal-epithelial interface.  


The stromal cells stain as follows:
The stromal cells stain as follows:

Revision as of 15:42, 16 May 2016

Uterine prolapse is a frequent benign pathology of the uterus and a common reason for hysterectomy.

General

  • Clinical diagnosis.
  • A common indication for a total hysterectomy.
  • Hysterectomy specimen usually comes with some vaginal mucosa.
  • Parous women, usually menopausal.[1]
  • Possibly obesity - studies vary.[2]

Gross

  • Long cervix.

Microscopic

Features:

  • Uterus: non-specific.
  • Vaginal mucosa: (focal) keratinization due to rubbing - common finding.

Note:

  • Benign stromal atypia may be seen.[3][4]

Images

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Submitted as "Uterine Cervix", Excision:
- Squamous mucosa with hyperplasia, parakeratosis, and stromal atypia, see comment.
- NEGATIVE for dysplasia and NEGATIVE for evidence of malignancy. 

Comment:
The stromal atypia is favoured to be benign change, as it is without significant proliferation, 
not mass forming and near the stromal-epithelial interface. 

The stromal cells stain as follows:
POSITIVE: vimentin, ER.
NEGATIVE: AE1/AE3, CD10.
PROLIFERATION (Ki-67): <1%.

Block letters

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH FOCAL KERATINIZATION OTHERWISE WITHIN NORMAL LIMITS.
- NONPROLIFERATIVE ENDOMETRIUM.
UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH KERATINIZATION, OTHERWISE WITHIN NORMAL LIMITS.
- CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE SMOOTH MUSCLE AND SEROSA WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

Denudated exocervix

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND EXOCERVICAL DENUDATION,
  NO EVIDENCE OF DYSPLASIA.
- CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE CORPUS WITH BENIGN HYALINIZED NODULE.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
Levels were cut on the uterine cervix sections (A1 and A2).

Focal ulceration

- UTERINE CERVIX WITH PARAKERATOSIS, ACANTHOSIS, CHRONIC INFLAMMATION, AND FOCAL
  ULCERATION ASSOCIATED WITH GRANULATION TISSUE FORMATION.
- PARTIALLY CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE CORPUS WITH LEIOMYOMA.
- NO EVIDENCE OF DYSPLASIA.
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

With endometrial polyp

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- BENIGN ENDOMETRIAL POLYP WITH NONPROLIFERATIVE ENDOMETRIAL GLANDS.
- UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND FOCAL EXOCERVICAL DENUDATION,
  NO EVIDENCE OF DYSPLASIA.
- VERY WEAKLY PROLIFERATIVE ENDOMETRIUM, MOSTLY ATROPHIC APPEARING, NEGATIVE FOR
  ENDOMETRIAL HYPERPLASIA.
- UTERINE CORPUS WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

See also

References

  1. Mladenović-Segedi, L.; Segedi, D.. "[Most important etiologic factors in the development of genital prolapse].". Srp Arh Celok Lek 138 (5-6): 315-8. PMID 20607975.
  2. Thubert, T.; Deffieux, X.; Letouzey, V.; Hermieu, JF. (Jul 2012). "[Obesity and urogynecology: a systematic review].". Prog Urol 22 (8): 445-53. doi:10.1016/j.purol.2012.03.009. PMID 22732579.
  3. Nucci, MR.; Young, RH.; Fletcher, CD. (Feb 2000). "Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma.". Am J Surg Pathol 24 (2): 231-40. PMID 10680891.
  4. Rodrigues, MI et al. (April-June 2009). [http://www.medigraphic.com/pdfs/patrevlat/rlp-2009/rlp092e.pdf "Atypical stromal cells as a diagnostic pitfall in lesions of the lower female genital tract and uterus: a review and presentation of some unusual cases"]. Patología 47 (2): 103-7. http://www.medigraphic.com/pdfs/patrevlat/rlp-2009/rlp092e.pdf.