2016-11-13 O&G Surgical Pathology

Todays blog is aimed at the UCL 5th Year Medical Students who attended on Thursday and the SSC UCL Students that attended on Friday

O&G Surgical Pathology Topics covered

Physiological uterine enlargement (pregnancy)

• Post Partum Haemorrhage due to Placenta Accreta

Pathological causes of an enlarged uterus :-

• Fibroids showing
  • Red degeneration (ischaemia)
  • Calcification and Bony metaplasia
  • Cystic and Myxoid Degeneration
  • Malignant change (Leiomyosarcoma)
• Adenomyosis
• Benign Endometrial polyp
• Adenocarcinoma of the uterus
  • Affects on staging  – Depth of invasion  – Invasion of the endocervix

Ovarian cysts :- Follicular Cysts , Polycystic Ovary , Luteal cyst (not illustrated)

Other benign Cysts  : –

• Simple Cyst
• Endometriotic Cyst (classic chocolate cyst)
  • Endometriosis in other areas
    • Pounch of Douglas
    • Surface of the uterus
    • Umbilical (diferential diagnosis discussed)
    • Colonic Endometrioma (rare)
    • Lungs (rare)

Serous Cystadenoma (incl Serous Cystadenofibroma)

Mucinous Cystadenoma

Benign Dermoid Cyst (Benign Cystic Teratoma)

Malignant change (SCC)

Other Teratomas

• Struma Ovarii
• Struma Carcinoid (not shown)

Adenocarcinoma of the ovary

• Omental metastasis

Other ovarian pathology shown

Thecoma/Fibroma

• Association with Meigs’ Syndrome
• Named after Joe Meigs
• https://en.wikipedia.org/wiki/Joe_Vincent_Meigs

Granulosa Cell Tumour

Transitional Cell Tumour of the ovary – Brenner  (discussed)

• named after Fritz Brenner
• https://en.wikipedia.org/wiki/Fritz_Brenner_(pathologist)

Other pathology shown

Ectopic pregnancy

Friday group only

• a Placenta shown with two umbilical vessels
  • associatedwith foetal abnormality
• A Hydatidiform Mole with an unusal history
• https://en.wikipedia.org/wiki/Molar_pregnancy

Postmenopausal uterus resected for prolapse

Topics not covered but worth reading up

Cervical Pathology , CIN , Carcinoma (SCC & adeno)

Vulval pathology – eg Lichen Sclerosis

Placenta pathology eg when to send to pathology

Other info

For those liking to listen to the radio whilst working

In our time Radio 4

Microbiology        http://www.bbc.co.uk/programmes/b007753d

Reference              https://en.wikipedia.org/wiki/Ignaz_Semmelweis

Penicillin            http://www.bbc.co.uk/programmes/b07dnnkm

Anatomy             http://www.bbc.co.uk/programmes/p005488j

The Heart           http://www.bbc.co.uk/programmes/p003c1bh

Hippocrates        http://www.bbc.co.uk/programmes/b014gdqq

Galen                     http://www.bbc.co.uk/programmes/b03c4dys