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Difference between revisions of "Endometrium"
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The '''endometrium''' is typically biopsied because of abnormal bleeding. | The '''endometrium''' is typically biopsied because of abnormal bleeding. | ||
===Indications=== | |||
Biopsies done for bleeding: | Biopsies done for bleeding: | ||
*Too much bleeding (if premenopausal) - ''AUB'' = abnormal uterine bleeding. | *Too much bleeding (if premenopausal) - ''AUB'' = abnormal uterine bleeding. | ||
*Post-menopausal bleeding. | *Post-menopausal bleeding. | ||
*Dysfunctional uterine bleeding | *Dysfunctional uterine bleeding [[AKA]] ''DUB'' - may get D&C if they fail medical management.<ref>URL: [http://emedicine.medscape.com/article/257007-treatment http://emedicine.medscape.com/article/257007-treatment]. Accessed on: 15 July 2010.</ref> | ||
**DUB is diagnosed if other causes of bleeding are excluded | **DUB is diagnosed if other causes of bleeding are excluded. | ||
===Normal microscopic findings=== | |||
*Endocervical glands are commonly seen, as is endocervical mucous. | *Endocervical glands are commonly seen, as is endocervical mucous. | ||
**This is 'cause the gynecologist scrapes some off on the way in or out. | **This is 'cause the gynecologist scrapes some off on the way in or out. | ||
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#Glands round? | #Glands round? | ||
#*Round is normal. | #*Round is normal. | ||
#*Irregular - may be seen in menses, endometrial hyperplasia | #*Irregular - may be seen in menses, endometrial hyperplasia, disordered proliferative endometrium. | ||
#Glands pseudostratified? | #Glands pseudostratified? | ||
#* | #*Pseudostratified glands are normal in the proliferative phase. | ||
===High power=== | ===High power=== | ||
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==Dating endometrium== | ==Dating endometrium== | ||
===Proliferative phase=== | ===Proliferative phase=== | ||
* | *Glands: straight, tubular, tall pseudostratified columnar cells, mitotic figures, NO vacuolation, NO mucus secretion. | ||
**Key features: pseudostratification, mitoses. | **Key features: pseudostratification, mitoses. | ||
* | *Stroma: cellular stroma (spindle cells), mitoses. | ||
Note: | Note: | ||
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===Secretory phase=== | ===Secretory phase=== | ||
*Early secretory phase - post-ovulatory day 1-5: | *Early secretory phase - post-ovulatory day 1-5: | ||
** | **Glands: secretory vacuoles. | ||
***First basal to the epithelial nuclei (infranuclear vacuoles). | ***First basal to the epithelial nuclei (infranuclear vacuoles). | ||
***Then apical to the epithelial nuclei (supranuclear vacuoles). | ***Then apical to the epithelial nuclei (supranuclear vacuoles). | ||
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**Stroma: Edema (empty space around the glands). | **Stroma: Edema (empty space around the glands). | ||
*Late secretory phase ( | *Late secretory phase (beginning) - post-ovulatory day 9-12: | ||
**Stroma: | **Stroma: | ||
***Spiral arterioles. | ***Spiral arterioles. | ||
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==Endometrial carcinoma== | ==Endometrial carcinoma== | ||
{{main|Endometrial carcinoma}} | {{main|Endometrial carcinoma}} | ||
Most common gynecologic malignancy.<ref name=pmid19332248>{{cite journal |author=Lu KH |title=Management of early-stage endometrial cancer |journal=Semin. Oncol. |volume=36 |issue=2 |pages=137–44 |year=2009 |month=April |pmid=19332248 |doi=10.1053/j.seminoncol.2008.12.005 |url=}}</ref> | |||
==See also== | ==See also== | ||