7 - Endometriosis & :Abnormal growth of endometrial...

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Unformatted text preview: 2003-11-31Endometriosis & Adenomyosis2003-11-32Endometriosis2003-11-33Definition:Abnormal growth of endometrial tissue outside the uterine cavity.2003-11-34Incidence and Prevalence:•Increase significantly•Range from 1 ~ 50%General population:1 ~ 2%Infertile women:30 ~ 50%•Occurs primarily in women in 25 ~ 45s2003-11-35Pathogenesis:•Implantation Theory Retrograde Menustration TheorySampson ~ 1921•Lymphatic and Vascular Dissemination TheoryJavert ~ 1952•Coelomic TheoryMeyer•Genetic Theory•Immune System Dysfunction ~immunologic theory~2003-11-36Genetic factors&•Familial clusteringof endometriosis is a common clinical observation.•In families with endometriosis ~ the disease is often confined to the maternal line ~ and is 7 times more common in first-degree relativesthan in the general population.•In future studies ~evaluation of DNA polymorphismmay identify specific genes involved in the development of endometriosis.2003-11-37Immunologic Theory&•Lose control of immunologic balance•Both cellular immunity and humoral immunity change.1)Macrophage↑release IL–1 ~ IL–6 ~ TNF ~ EGF ~ FGF etc. stimulate T ~ B lymphocyte proliferation and activation2)Activity of killer cell ~ NK cell and T cell ~↓3)Produce anti–endometrium antibody4)Abnormal expression of CAMs ~ cell adhesion molecules ~2003-11-38•The pathogenesis is unclear.•multifactor2003-11-39Pathology–macroscopic appearance&1&&•The commonest sites ~1.Ovary ~ chocolate cyst ~2.Peritoneum of the recto–vaginal cul–de–sac of the Pouch of Douglas3.Utero–sacral ligaments 4.Sigmoid colon5.Broad ligament2003-11-310This is a section through an enlarnged 12 cm ovary to demonstrate a cystic cavity filled with old blood typical for endometriosis with formation of an endometriotic, or "chocolate", cyst. 2003-11-3112003-11-312Pathology– macroscopic appearance &2&&•Less common sites ~1.Cervix2.Round ligament3.Urinary system ~ bladder ~ ureter ~4.Umbilicus5.Appendix6.Laparotomy scars2003-11-313Multiple appearances ofendometriosisimplants&•Brownish ~ discolored peritoneum•Superficial peritoneal ecchymosis•Raised ~ reddish ~ superficial nodules...
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7 - Endometriosis & :Abnormal growth of endometrial...

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