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Diseases of the female genital organs and mammary glands. Pathology of pregnancy.



Diseases of the female genital organs are divided into: 1) dishormonal; 2) inflammatory: 3) tumor. Among dishormonal diseases, glandular hyperplasia of the uterine mucosa and uterine pseudo-erosion are frequent. With glandular endometrial hyperplasia, its sharp thickening occurs due to polypous outgrowths. Histologically distinguish glandular-cystic and atypical hyperplasia, or diffuse adenomatosis.

Endocervicosis (pseudo-erosion) of the cervix is ​​located at the external uterine pharynx at the border of the stratified squamous epithelium of the cervix and the prismatic epithelium of its channel. Endocervicosis is represented by proliferation of high prismatic epithelium in the form of papillae (papillary pseudo-erosion) or glands (glandular pseudo-erosion). Due to the abundance of blood vessels, it has the appearance of a bright red spot, which creates an imitation of erosion. Atypical glandular endometrial hyperplasia and cervical endocervicosis are considered precancerous diseases.

Inflammatory processes in the female genital organs are often a manifestation of the underlying disease (sepsis, tuberculosis, syphilis, gonorrhea). The most common endometritis, which can be acute and chronic. Among tumor diseases of the female genital organs, cancer of the cervix and uterus, as well as chorionepithelioma, is of great clinical importance.

Pregnancy pathology includes eclampsia, ectopic pregnancy, spontaneous abortion, premature birth, cystic drift. After childbirth or abortion, a generic infection of the uterus, placental polyp, and chorionepithelioma may develop.

Eclampsia is one of the types of toxicosis of pregnancy. The most severe changes are caused by a combination of generalized intravascular coagulation, with hemorrhages, massive necrosis with hemorrhages in the liver, mesangioproliferative glomerulonephritis with necronephrosis and hemorrhages. Hepatic-renal failure is becoming one of the leading causes of death.

Bubble drift is a change in the placenta, hydropic and cystic transformation of chorionic villi, which is accompanied by proliferation of epithelium and syncytial cells. As a result, the villi turn into transparent vesicle-like formations resembling clusters of grapes. The ingrowth of altered villi into the thickness of the muscle layer of the uterus indicates a destroying cystic skid that can go into chorionepithelium.

Dyshormonal diseases of the breast include its benign dysplasia (mastopathy, Reclus-Shimmelbusch disease), which is characterized by a violation of the differentiation of the epithelium, its atypism, a violation of the histostructure, but without invasion of the basement membrane and with the possibility of reverse development. Its occurrence is associated with an imbalance in estrogen balance.

There are two main forms of mastopathy: non-proliferative and proliferative. Breast inflammation (mastitis) can be acute and chronic.

Fibroadenoma is a benign breast tumor. It can be intraductal, intralobular and phyloid (leaf-shaped). The types of breast cancer include: a) non-infiltrating lobular cancer (lobular — cancer in place ”); b) non-infiltrating intraductal cancer (ductal cancer in place); c) Paget's disease.
Breast cancer produces both lymphogenous and hematogenous metastases, and relapses may also occur.

Micropreparations

1. Intraductal fibroadenoma of the mammary gland (okr. GE).

Designations: 1) slit-like glandular formations (“deer horns”); 2) proliferation of connective tissue around the ducts; 3) compression of the ducts of the mammary gland.

2. Chorionepithelial uterus (okr. GE).

Designations: 1) tumor cubic cells of Langhans; 2) tumor cells of syncytium; 3) blood clots between tumor cells; 4) foci of hyalinosis.

3. Papillary cystadenoma of the ovary (okr. GE).

Designations: 1) connective tissue capsule of a cyst; 2) papillary proliferation of the epithelial lining of the cyst; 3) plethora of blood vessels; 4) tissue atypism of the tumor.

4. Adenocarcinoma of the uterus (okr. GE).

Designations: 1) atypism and polymorphism of the glands of the tumor tissue; 2) pronounced cellular atypism of the glandular epithelium; 3) invasive tumor growth.

5. Squamous cell carcinoma of the cervix with signs of keratinization (env. GE).

Designations: 1) layers of atypical polymorphic squamous tumor cells; 2) keratinization foci (“cancerous pearls”); 3) invasive tumor growth.

6. Hyperplasia of the prostate gland (env. HE).

Designations: 1) proliferation of glandular ducts; 2) cystic expanded glands; 3) fibromatous proliferation; 4) papillary proliferation of ductal epithelium; 5) adenoma capsule.

7. Adenocarcinoma of the prostate gland (okr. GE).

Designations: 1) solid clusters of polymorphic glands; 2) pronounced cellular atypism of the glandular epithelium;

3) invasive tumor growth.

8. Placental polyp (okr. GE).

Designations: 1) connective tissue organization of the polyp 2) proliferation of syncytium cells and Lanhgans cells 3) chorionic villi 4) foci of hyalinosis and hemorrhage.

Macro preparations

1. Purulent endometritis.

2. Breast cancer.

3. Symptom - “retracted nipple” in breast cancer.

4. Teratoblastoma of the ovary.

5. Dermoid ovarian cyst.

Test questions topics

1. Classification of diseases of the female genital organs.

2. Etiology, pathogenesis, morphology, complications and outcomes of dishormonal diseases of female genital organs.

3. Etiology, pathogenesis, morphology, complications, outcomes of inflammatory diseases of the female genital organs.

4. Etiology, pathogenesis, morphology, complications, outcomes of diseases associated with pregnancy pathology.

5. Histogenesis, morphology, complications of tumor diseases of the female genital organs.

6. Histogenesis, morphology, complications of dishormonal and tumor diseases of the mammary gland.

Situational task

A 45-year-old woman performed diagnostic curettage of the uterine mucosa in connection with heavy bleeding. A histological examination of the scraping revealed a large number of elongated sinuous glands. D hyperplasia of stromal cells.

1. What is the pathological process, its possible outcome.

2. What are the possible histological options for this process.

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Diseases of the female genital organs and mammary glands. Pathology of pregnancy.

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