Uterine tumors can be benign or malignant. Common benign tumors include endometrial polyps which present as exophytic masses in the uterus and are usually asymptomatic. Malignant tumors include endometrial carcinoma and endometrial stromal sarcoma. Endometrial hyperplasia, where the endometrial glands proliferate relative to the stroma, is a risk factor for endometrial carcinoma. Gestational trophoblastic diseases range from complete and partial hydatidiform moles to invasive mole, choriocarcinoma, and placental site trophoblastic tumor. Choriocarcinoma is highly malignant and metastatic while placental site trophoblastic tumor has a more indol
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
Lecture class on pathology of breast for 3rd & 4th year MBBS students based on "Robbins & Cotran: Pathologic Basis of Disease'. Images are collected from internet.
Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. In gestational trophoblastic disease (GTD), a tumor develops inside the uterus from tissue that forms after conception (the joining of sperm and egg).
Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. The cells that form gestational trophoblastic tumours are called trophoblasts and come from tissue that grows to form the placenta during pregnancy.
Part 1 of the Epidemiology Exercises for the Practical Exam in the subject of Social and Preventive Medicine at Shadan Institute of Medical Sciences
Covering Questions 1 to 10 along with their detailed answers
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
3. Endometrial polyp
Exophytic masses – 0.5 to 3cms, single or multiple,
sessile
Pedunculated masses
Asymptomatic . But may bleed when they ulcerate
or undergo necrosis
Stroma – cytogenetic rearrangements, hence,
neoplastic.
Glands - reactive, with hyperplasia or atrophy, in
secretory phase.
Tamoxifen
Atrophic polyps – post menopausal women
Adenocarcinoma arising from polyp – very rare
4.
5.
6. Endometrial hyperplasia
Definition: An increased proliferation of the
endometrial glands relative to the stroma,
resulting in an increased gland to-stroma ratio
when compared with normal proliferative
endometrium.
The most common cause of dysfunctional uterine bleeding
(DUB) & is associated with hyperestrogenemia
7.
8. Types of hyperplasia: kurman and norris
1. Simple hyperplasia (cystic hyperplasia, mild
hyperplasia) Cystic dilated glands, non-neoplastic, due
to anovulatory cycles.
2. Complex hyperplasia (adenomatous hyperplasia)
Overcrowded, closely opposed glands. Some of these
are neoplastic contain PTEN (Phosphatase and tensin
homolog mutations) & considered as EIN. PTEN-
tumor suppressor gene
3. Atypical hyperplasia (complex / adenomatous
hyperplasia with atypia) Overcrowded glands with
cytological atypia. Most cases of this category are
neoplastic (EIN) and many contain PTEN mutations
9.
10.
11. Associated conditions
Obesity (peripheral conversion of androgens to
estrogens)
Menopause
Polycystic ovarian syndrome [PCOS]
Functioning granulosa cell tumors of the ovary
Excessive ovarian cortical function (cortical stromal
hyperplasia)
Prolonged administration of estrogenic substances
(estrogen replacement therapy
12. Endometrial hyperplasia:
• It is an important cause of
abnormal uterine bleeding.
• A subset (EIN) is considered
a risk factor for endometrial
carcinoma.
• The risk of carcinoma
increases as function of the
degree of atypia.
• Both endometrial hyperplasia
and adenocarcinoma are
associated with
hyperestrogenism,
microsatellite instability, and
mutation of PTEN gene.
14. Endometrial carcinoma
7% of all invasive carcinomas in women
Incidence at present is more than cervix carcinoma as
better detection mechanisms have been employed for ca
cervix.
RISK FACTORS :
Obesity,
nulliparity,
early menarche & late menopause,
granulosa cell tumor of the ovary,
breast cancer,
diabetes,
hypertension,
infertility&
unopposed estrogen
23. Clinical features:
Post menopausal women – 55-60 yrs of age.
Irregular or postmenopausal vaginal bleeding with
excessive leukorrhea
Uterine enlargement
Diagnosis: Purely based on the biopsy sample taken
or fractional curettage sample.
25. Prognosis
Stage I well-differentiated or moderately
differentiated endometrioid carcinomas -
Surgery, alone or in combination with irradiation
90% 5-year survival in stage I (grade 1 or 2)
disease
Stage 2 - 75%
Stage 3 - 50% or less
26. Malignant Mixed Müllerian Tumors
Malignant mixed müllerian tumors
(MMMTs) (also referred to as
carcinosarcomas) are endometrial
adenocarcinomas with a malignant
mesenchymal component.
Uterine mesenchymal elements - stromal sarcoma,
leiomyosarcoma
Heterologous malignant cell types - rhabdomyosarcoma,
chondrosarcoma
Due to multiple combined mutations - PTEN, TP53, and
PIK3CA
34. Gestational trophoblastic diseases:
Gestational trophoblastic disease
encompasses a spectrum of tumors and
tumor-like conditions characterized by
proliferation of placental tissue
The major disorders of this type are
1. Hydatidiform mole (complete and partial)
2. Invasive mole
3. Choriocarcinoma
4. Placental site trophoblastic tumor (PSTT)
35. Hydatidiform mole:
Characterized histologically by cystic swelling of the
chorionic villi, accompanied by variable trophoblastic
proliferation
An increased risk of persistent trophoblastic disease
(invasive mole) or choriocarcinoma
Hyadatidiform
mole
Complete Partial
36.
37. Delicate, friable mass of thin-walled, translucent,
cystic, grapelike structures consisting of swollen
edematous (hydropic) villi
Chorionic villi are enlarged, scalloped in shape
with central cavitation (cisterns), and are
covered by extensive trophoblast proliferation
that involves the entire circumference of the villi
In contrast, in partial moles, only a fraction of the
villi are enlarged and edematous.
39. Spontaneous miscarriage or undergo curettage
because of ultrasound findings of abnormal villous
enlargement
Greatly elevated HCG levels
Curettage
The patients are subsequently monitored for 6
months to a year to ensure that HCG levels
decrease to non-pregnant levels
2.5% - progress to Choriocarcinoma
40. Invasive mole
Invasive mole is defined as a mole that
penetrates or even perforates the uterine
wall.
There is invasion of the myometrium by hydropic
chorionic villi, accompanied by proliferation of
both cytotrophoblasts and syncytiotrophoblasts.
The tumor is locally destructive and may invade
parametrial tissue and blood vessels.
Hydropic villi may embolize to distant sites, such
as lungs and brain, but do not grow in these
organs as true metastases
41. Choriocarcinoma :
Malignant neoplasm of trophoblastic cells derived
from a previously normal or abnormal pregnancy
Rapidly invasive and metastatic
50 % arise from hydatidiform moles,
25% in previous abortions,
22% follow normal pregnancies,
remainder occurring in ectopic pregnancies.
42. Choriocarcinoma is a
soft, fleshy, yellow-white
tumor that usually has
large pale areas of
necrosis and extensive
hemorrhage
43. No chorionic villi
Proliferation of
syncytiotrophoblasts
and cytotrophoblasts
Large hemorrhagic
areas
Abnormal mitosis
Highly Invasive –
myometrium, blood
vessels, adjacent
organs
44.
45.
46. Clinical features:
Irregular vaginal spotting of a bloody, brown fluid.
This discharge may appear in the course of an
apparently normal pregnancy, after a
miscarriage, or after curettage.
High propensity for hematogenous spread-
discovered in metastatic stage
The lungs (50%) and vagina (30% to 40%),
followed by, brain, liver, bone and kidney
Chemotherapy – Methotrexate , 100 % cure rate.
47. Placental Site Trophoblastic Tumor (PSTT):
2% gestational trophoblastic tumours
Neoplastic proliferations of extravillous trophoblasts,
also called intermediate trophoblasts
Uterine mass, accompanied by abnormal uterine
bleeding or amenorrhea and moderately elevated
HCG
Histologically : Malignant trophoblastic cells diffusely
infiltrating endomyometrium.
It may follow a normal pregnancy (half of the cases),
spontaneous abortion, or hydatidiform mole.
Excellent prognosis,
10% to 15% of women die of disseminated disease
Editor's Notes
23 Endometrial hyperplasia. A, Hyperplasia without atypia. Note architectural abnormalities including mild glandular crowding and cystic glandular
dilatation. B, Hyperplasia without atypia demonstrating increased glandular crowding with areas of back-to-back glands and cytologic features similar to proliferative endometrium. C, Atypical hyperplasia with further increase in glandular crowding and abnormal cytologic features. D, High magnification of atypical hyperplasia showing rounded, vesicular nuclei with prominent nucleoli (arrow).
schematic depicting the development of type I endometrial carcinoma arising in the setting of hyperplasia. B, Schematic diagram of the
development of type II endometrial carcinoma. The most common molecular genetic alterations are shown at the time they are most likely to occur during the progression of the disease. *MI, Microsatellite instability. CTNNB1, beta-catenin gene; PPP2R1A, PP2A gene; CCNE1, cyclin E gene.
Type I endometrial carcinoma. A, Endometrial adenocarcinoma presenting as a fungating mass in the fundus of the uterus. B, Well-differentiated
(grade 1) endometrioid adenocarcinoma with preserved glandular architecture but lack of intervening stroma. C, Moderately differentiated (grade 2) endometrioid
adenocarcinoma with glandular architecture admixed with solid areas. D, Poorly differentiated (grade 3) endometrioid adenocarcinoma with a predominantly
solid growth pattern.
Type II endometrial carcinoma. A, Endometrial intraepithelial carcinoma, the precursor to serous carcinoma showing malignant cells (arrow) with
morphologic features identical to serous carcinoma lining the surfaces of the endometrial glands without obvious stromal invasion. B, Strong, diffuse expressionof p53 as detected by immunohistochemistry in endometrial intraepithelial carcinoma. C, Serous carcinoma of the endometrium with papillary growth pattern consisting of malignant cells with marked cytologic atypia including high nuclear-to-cytoplasmic ratio, atypical mitotic figures, and hyperchromasia. D, As with the previous lesion, there is an accumulation of p53 protein in the nucleus.
