Atlas on bethesda system for reporting cervical cytologyAshish Jawarkar
This is an atlas with more nearly 100 images, authentic taken from NCI web atlas. Useful to understand and report pap smears. The subject has been presented in a way which will help students reproduce in exams.
Atlas on bethesda system for reporting cervical cytologyAshish Jawarkar
This is an atlas with more nearly 100 images, authentic taken from NCI web atlas. Useful to understand and report pap smears. The subject has been presented in a way which will help students reproduce in exams.
Discussion on Papillary carcinoma thyroid - category, types with definitions, other DD for pap ca thyroid along with a whole lot of beautiful cytology pictures - a feast to the eyes
An array of presentation of lymphoma spillover in the peripheral smear and bone marrow. All types of lymphomas are discussed along with a bouquet of HPE pictures
Discussion on types, pathogenesis of hypersensitivity. Referred from Robbins 10th edition. Prepared by a pathology Postgraduate for 2nd year MBBS students
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
2. NORMAL MENSTRUAL PHASES
NAME OF THE PHASE AVERAGE DURATION RANGE
MENSES 5 DAYS 1 – 7 DAYS
PROLIFERATIVE PHASE 10 DAYS 9 – 20 DAYS
SECRETORY PHASE 14 DAYS 14 DAYS (CONSTANT)
MORPHOLOGICAL
DATE
CHRONOLOGICAL
DATE
VS
3. GLAND STROMAL RATIO (UNDER 10X)
1:1 MORE GLANDS MORE STROMA
NORMAL CYCLING
ENDOMETRIUM
LATE SECRETORY ENDOMETRIA DECIDUA
DYSFUNCTIONAL UTERINE
BLEEDING
MENSTRUATION ATROPHY
INFERTILITY ENDOMETRIAL HYPERPLASIA
CARCINOMAS
MONOPHASIC SPINDLE CELL
PROLIFERATIONS
- SMOOTH MUSCLE
NEOPLASMS
- ENDOMETRIAL STROMAL
NEOPLASM
- SPINDLED EPITHELIAL
NEOPLASM
- UTERINE SARCOMAS
4. NORMAL PROLIFERATIVE ENDOMETRIUM
• EPITHELIUM
• PSEUDOSTRATIFIED
• MITOTICALLY ACTIVE
• ELONGATED CELLS
• STRATUM FUNCTIONALIS
• NON BRANCHING
• NON BUDDING
• SIMILAR SHAPED & EVENLY
DISTRIBUTED GLANDS
• STROMA
• MITOTICALLY ACTIVE
• MONOMORPHOUS
• UNDIFFERENTIATED STROMAL
CELLS
• SCANT CYTOPLASM
• INDISTINCT CELL MARGINS
• VASCULATURE
• UNIFORM, ARBORIZING AND
THIN WALLED VESSELS
7. INTERVAL ENDOMETRIUM
• GLANDS
• COILED
• <50% OF EPITHELIAL CELLS WITH SUB NUCLEAR VACUOLATION
• EVIDENCE OF SECRETION
• EVIDENCE OF OVULATION
• APPEARANCE OF DISTINCTIVE NUCLEOLAR CHANNEL SYSTEM
• POD 1 & 2 ALSO SHOW THESE FINDINGS
8. EARLY SECRETORY PHASE (POD 2 – 5)
• GLANDS
• COILED
• >50% CELLS WITH LARGE
SUBNUCLEAR CYTOPLASMIC
VACUOLES
• MITOTIC FIGURES PRESENT
• STROMA
• NON PREDECIDUATED
• CLINICOPATH CORRELATION
• H/O MID CYCLE SPOTTING
• MITTELSCHMERZ
18. SECRETORY GLAND
VACUOLATED
POD 2
UNIFORM SNV
>50%
NUCLEAR
PSEUDOSTRATIFICATION
MITOTIC
FIGURES
POD 3 POD 4
LUMINAL
POSITION OF
VACUOLES
RARE MITOTIC
FIGURES
POD 5
SECRETIONS
VACUOLES
INFREQUENT
19. SECRETORY NON VACUOLATED
NON DECIDUALISED STROMA
POD 6
PROMINENT
SECRETION
POD 7
STROMAL
EDEMA +
POD 8
STROMAL
EDEMA +++
PRE
DECIDUAL
LATE
SECRETORY,
MENSTRUAL
20. SECRETORY NON VACUOLATED
NO CRUMBLING OF STROMA
POD 9
SPIRAL
ARTERIES +
POD 10
PERIARTERIAL
CUFFS +
POD 11
PREDECIDUA
ISLANDS
POD 12
COALESCENCE
OF ISLANDS
POD 13
STROMAL
GRANULOCYTES
+
POD 14
RBC IN
STROMA
CRUMBLED
STROMA
MENSTRUATION
23. ESTROGENS
• PROMOTE THE GROWTH OF A NON SECRETORY ENDOMETRIUM
• ENDOGENOUS – CHRONIC ANOVULATION
• EXOGENOUS – HORMONE REPLACEMENT THERAPY
• PREDISPOSES TO
• ENDOMETRIAL HYPERPLASIA
• ENDOMETRIAL CARCINOMA (2-15 FOLD INCREASED RISK) – WELL
DIFFERENTIATED AND SUPERFICIAL WITH GOOD PROGNOSIS
24. PROGESTATIONAL AGENTS
• THERAPEUTIC & CONTRACEPTIVE PURPOSES
• CHANGES SEEN MAINLY IN STROMA – PSEUDODECIDUAL CHANGES
• GLANDS
• SMALL
• WIDELY SEPARATED
• ATROPHIC
• TAKES WEEKS TO RETURN TO NORMAL PATTERN ON
DISCONTINUATION
• ARIAS STELLA REACTION
25. ARIAS STELLA REACTION
• CAN BE FOCAL, EXTRA
ENDOMETRIAL
• GLANDS
• HYPERSECRETORY
• LARGE CELLS
• CYTOPLASM – EOSINOPHILIC,
ABUNDANT
• NUCLEI – IRREGULAR LARGE,
SMUDGED, PLEOMORPHIC
26. SYNTHETIC PROGESTERONE RECEPTOR
MODULATORS
• INDICATION
• ENDOMETRIOSIS
• UTERINE LEIOMYOMAS
• GLANDS
• ATROPHIC OR INACTIVE EPITHELIUM
• CYSTIC DILATED
• DYSSYNCHRONY BETWEEN GLANDS AND STROMA
• THICK WALLED CORDED VESSELS CLOSE TO SURFACE EPITHELIUM
• CILIARY METAPLASIA IS COMMON
27. TAMOXIFEN
• SYNTHETIC ANTI-ESTROGEN
• INDICATION : PROPHYLAXIS OF BREAST CARCINOMA
• PARADOXICAL ESTROGENIC EFFECT IN THE ABSENCE OF OVARIAN
OESTROGEN
• CAUSES
• HYPERPLASIAS
• POLYPS
• MALIGNANT TUMOURS
• ENDOMETRIAL CARCINOMA WITH BAD PROGNOSIS
28. GESTATIONAL ENDOMETRIUM
• EARLY
• COINCIDENCE OF
• GLANDULAR LUMINAL SECRETION
• PRE DECIDUALISATION
• STROMAL EDEMA
• FULLY DEVELOPED
• GLANDS
• FLATTENED OR CUBOIDAL LINING
• NUCLEAR INCLUSIONS – BIOTIN
ACCUMULATION
• SURROUNDED BY SHEETS OF
DECIDUA
• ASSOCIATED FINDINGS –
CHORIONIC VILLI, PLACENTA,
FETAL PARTS ETC
30. ACUTE ENDOMETRITIS
• INFLAMMATORY CELLS ARE
NORMALLY PRESENT ON DAYS
26,27,28
• ACUTE ENDOMETRITIS
• ABORTION
• POSTPARTUM STATE
• INSTRUMENTATION
• INFILTRATION & DESTRUCTION
OF GLANDS BY PMNs
32. ACTINOMYCES
• CENTRAL BRANCHING
FILAMENTS
• DIPHETHEROID FORMS
• DEVELOPS FOLLOWING
INSERTION OF IUD
HEMATOMETRA
• CERVICAL OCCLUSION
• MICROSCOPY
• DISAPPEARANCE OF MUCOSA
• LIPID CONTAINING HISTIOCYTIC
CELSS –
XANTHOGRANULOMATOUS
ENDOMETRITIS
• YELLOWISH-BROWN
CYTOPLASMIC PIGMENT –
CEROID CONTAINING HISTIOCYTIC
GRANULOMA
33. ENDOMETRIAL TUBERCULOSIS
• SYMPTOMS
• MENSTRUAL ABNORMALITY
• INFERTILITY
• AFB IN TUBERCLES/CULTURE
• GRANULOMAS CONCENTRATE IN SUPERFICIAL LAYERS
• TAKE EM BX DURING LATE SECRETORY PHASE
34. OTHERS
• CHLAMYDIA – IHC OF ANTIGENS OR PCR, PLASMA CELLS
• VIRAL INFECTIONS – CMV, HPV – GRANULOMATOUS
• COCCIDIODOMYCOSIS – FROM LUNG INFECTION
• POSTOPERATIVE GRANULOMAS – ENDOMETRIAL ABLATION
• SARCOIDOSIS
• GRANULOMATOUS REACTION SPREADS TO MYOMETRIUM
35. HOW TO AVOID OVERDIAGNOSIS?
• ABNORMAL CYCLIC PATTERN
• FOCAL MONONUCLEAR INFILTRATE
• INFLAMMATORY CELLS IN THE
GLANDULAR LUMINA
• DENSE STROMA
• A STELLATE STROMAL PATTERN OF
PROLIFERATION
• FOCI OF NECROSIS OR CALCIFICATION
36. METAPLASIA - SQUAMOUS
• MOST COMMON – PRE MENOPAUSAL, PCOS
• FRANK KERATINIZATION – ICTHYOSIS UTERI
• NON KERATINISED SQUAMOID CELLS
• DIFFUSE – ADENOACANTHOSIS
• AGGREGATES - MORULES
• MORULAR METAPLASIA
• FUNCTIONALY INERT
• NO SEX HORMONE RECEPTORS
• LOW PROLIFERATION RATE
• CDX2 – INTESTINAL TRANSCRIPTION FACTOR
+VE
37. METAPLASIA – CILIATED (TUBAL)
• SCATTERED CILIATED CELLS ARE
NORMAL IN THE ENDOMETRIUM
• MARKEDLY INCREASED – METAPLASIA
• COMMON IN ATROPHIC
ENDOMETRIUM
• NOT A SIGNIFICANT RISK FACTOR FOR
ADENO CARCINOMA
38. METAPLASIA - PAPILLARY
• SYNCTITIAL TO PAPILLARY
AGGREGATES OF EOSINOPHILIC
CELLS
• ENDOMETRIAL BREAKDOWN
39. MUCINOUS METAPLASIA
• MORPHOLOGICALLY,
HISTOCHEMICALLY &
ULTRASTRUCTURALLY SIMILAR TO
ENDOCERVICAL MUCOSA
• COMMON IN ENDOMETRIAL
POLYPS
EOSINOPHILIC METAPLASIA
• CELLS WITH ABUNDANT
EOSINOPHILIC CYTOPLASM
HOBNAIL & CLEAR CELL METAPLASIA
• EPITHELIUM – CLEAR, TALL CELLS
WITH APICALLY LOCATED NUCLEI
40. ADENOMYOSIS
• PRESENCE OF ISLANDS OF
ENDOMETRIAL GLANDS AND
STROMA DEEP WITHIN THE
MYOMETRIUM
• NON FUNCTIONAL – BASAL
LAYER OF ENDOMETRIUM
• LESS PROLIFERATIVE RATE
• FOUND IN PROLIFERATIVE
PHASE
ENDOMETRIOSIS
• OCCURRENCE OF
ENDOMETRIAL TISSUE OUTSIDE
THE UTERUS
• FUNCTIONAL LAYERS OF THE
ENDOMETRIUM
• MORE PROLIFERATIVE RATE
• PHASE CHANGES OCCORDING
TO CYCLE
41. ADENOMYOSIS & ENDOMETRIOSIS
THEORIES
• CONGENITAL MULLERIAN OR
WOLFFIAN RESTS
• IMPLANTATION OF
ENDOMETRIUM
• LYMPHATIC OR
HEMATOGENOUS SPREAD
• SEROSAL METAPLASIA
SYMPTOMS
• PELVIC PAIN – VARIES WITH THE
MENSTRUAL PERIOD
• INFERTILITY
• RUPTURE AT THE TIME OF
PREGNANCY
43. ENDOMETRIOSIS GROSS
• BLUISH CYSTIC NODULES
SURROUNDED BY FIBROSIS
• MULTIPLE POLYPOIDAL MASSES
– ENDOMETRIOTIC POLYPOSIS
OVARIES
UTERINE
LIGAMENT
RECTOVAGINAL
SEPTUM
CUL DE SAC
PELVIC PERITONEUM
LARGE AND SMALL BOWEL AND
APPENDIX,
MUCOSA -CERVIX, VAGINA, & FALLOPIAN
TUBES
LAPAROTOMY SCARS
44. MICROSCOPY - ADENOMYOSIS
• ENDOMETRIAL GLANDS &
STROMA ARE SEEN IN THE
MYOMETRIUM AT A DISTANCE
OF AT LEAST OF 1 LOW POWER
(10X) FIELD FROM THE EM-MM
JUNCTION
• ALWAYS IN PROLIFERATIVE
PHASE
• STROMA PREDOMINANT –
STROMAL ADENOMYOSIS
45. MICROSCOPY - ENDOMETRIOSIS
• ENDOMETRIAL GLANDS AND
STROMA IN DENSE FIBROUS
MASS WITH FRESH AND OLD
HEMORRHAGE
• STROMAL COMPONENT –
SMOOTH MUSCLE METAPLASIA
47. WEAKLY PROLIFERATIVE ENDOMETRIUM
• TUBULAR GLANDS – CELLS
WITH PSEUDOSTRATIFIED
NUCLEI
• MITOTIC FIGURES – ABSENT
• COMMON & NORMAL
PATTERN
• PERIMENOPAUSAL
• POSTMENOPAUSAL
48. DISORDERLY PROLIFERATIVE ENDOMETRIUM
• ABSENCE OF UNIFORM GLANDULAR
DEVELOPMENT
• DYSSYNCHRONOUS GROWTH OF THE
FUNCTIONALIS
• NORMAL G:S RATIO
• IDENTICAL TO LATE PROLIFERATIVE
PHASE
• NORMAL IN PERIMENARCHAL AND
PERIMENOPAUSAL AGE GROUP
• ANOVULATORY CYCLES
• EXOGENOUS ESTROGEN THERAPY
49. ENDOMETRIAL HYPERPLASIA
• PROLIFERATING
ENDOMETRIUM – GLANDULAR
CROWDING
• INCREASED GLAND STROMAL
RATIO = 2:1 OR 3:1
• CLASSIFICATION (WHO 2014)
• ENDOMETRIAL HYPERPLASIA
WITHOUT ATYPIA
• ATYPICAL HYPERPLASIA
50. HYPERPLASIA WITHOUT ATYPIA
• GLANDS
• CYSTIC DILATION
• MINIMAL BUDDING
• LINING EPITHELIUM – NORMAL
LP
• NO CYTOLOGICAL ATYPIA
• STROMA
• COMPRESSED
