7 - 2003-11-31Endometriosis

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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 significantlyRange 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 1921Lymphatic and Vascular Dissemination TheoryJavert 1952Coelomic TheoryMeyerGenetic TheoryImmune System Dysfunction immunologic theory2003-11-36Genetic factorsFamilial 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 TheoryLose control of immunologic balanceBoth cellular immunity and humoral immunity change.1)Macrophagerelease IL1 IL6 TNF EGF FGF etc. stimulate T B lymphocyte proliferation and activation2)Activity of killer cell NK cell and T cell 3)Produce antiendometrium antibody4)Abnormal expression of CAMs cell adhesion molecules 2003-11-38The pathogenesis is unclear.multifactor2003-11-39Pathologymacroscopic appearance1The commonest sites 1.Ovary chocolate cyst 2.Peritoneum of the rectovaginal culdesac of the Pouch of Douglas3.Uterosacral 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 2Less common sites 1.Cervix2.Round ligament3.Urinary system bladder ureter 4.Umbilicus5.Appendix6.Laparotomy scars2003-11-313Multiple appearances ofendometriosisimplantsBrownish discolored peritoneumSuperficial peritoneal ecchymosisRaised reddish superficial nodules...
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7 - 2003-11-31Endometriosis

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