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The Reproductive System

The Reproductive System. MIS311 Imaging Pathology 2 Prepared by S. Beatty 1998. The Reproductive System. Infection and Inflammation Benign Growth & Proliferative Growth Female Infertility Disorders of the Male Reproductive System Disorders of the breast.

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The Reproductive System

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  1. The Reproductive System MIS311 Imaging Pathology 2 Prepared by S. Beatty 1998

  2. The Reproductive System • Infection and Inflammation • Benign Growth & Proliferative Growth • Female Infertility • Disorders of the Male Reproductive System • Disorders of the breast

  3. Infection & InflammationPelvic Inflammatory Disease (PID) • Any inflammatory condition of the female pelvic organs. • Usually caused through bacterial infection • Symptoms include: • fever, foul-smelling vaginal discharge, lower abdominal pain, pain with coitus. • If an abscess has developed then a fluid-filled mass may be palpated.

  4. PID • Fibrosis associated with PID may cause uterine tube blockage  infertility. • Ultrasound is often used with diagnosis of PID and associated pelvic abscesses. • Hysterosalpingogram is still performed in checking uterine tube patency.

  5. PID • May involve any organ, or combinations of organs, of the upper genital tract: • uterus, fallopian tubes or ovaries • in severe form the entire peritoneal cavity. • Usually PID is caused by sexually transmitted microorganisms that migrate from the vagina to the uterus, fallopian tubes and the ovaries.

  6. PID Under Ultrasound Tubo-ovarian abscess

  7. PID Under Ultrasound Chronic PID

  8. Normal PID Under Hysterosalpingogram

  9. Not So Normal PID Under Hysterosalpingogram

  10. Benign Growth and Proliferative Condition Benign Ovarian Cysts

  11. Benign Ovarian Cysts • Simple ovarian cysts are usually follicular or corpus luteum in origin. • Follicular cysts • Develops from a fominant ovarian follicle that does not release its own ovum but remains active • Not usually systematic • Usually require no treatment • They either regress or rupture spontaneously.

  12. Benign Ovarian Cysts • Symptoms include (if any): • Painful intercourse, chronic lower abdominal pain and menstrual irregularities. • Corpus Luteum Cysts • Develops from a mature corpus luteum - persists abnormally and continues to secrete progesterone. • The cyst contains blood or fluid that accumulates in the corpus luteum cavity.

  13. Benign Ovarian Cysts • Symptoms if any include: • Dull pelvic pain, delayed menstruation followed by irregular or heavier than normal bleeding. • Rupture can cause excruciating pain levels and requires immediate surgery • Oral contraceptives may be used to prevent cysts in the future

  14. Dermoid Cysts • The teratoma is the most common germ cell tumour and it contains a varying mixture of skin, hair, fatty elements and calcified teeth.

  15. Dermoid Cyst

  16. Dermoid Cyst

  17. Leiomyomas (Uterine Fibroids) • Benign tumours that develop from smooth muscle cells in the myometrium. • Most common benign tumours of the uterus. • Size of the tumour relates to hormonal fluctuations.

  18. Leiomyomas (Uterine Fibroids)

  19. Leiomyomas (Uterine Fibroids) • Characteristic mottled, mulberry, or popcorn type of appearance. • Able to be seen on plain abdominal x-ray as smooth or lobulated nodules with a stippled appearance. • A large Fibroid adenoma may occupy the entire pelvis.

  20. Leiomyomas (Uterine Fibroids) • I.V.P. • Persistent uterine opacification is seen in patients with underlying fibroid tumour. • The tumour typically presses on the fundus of the bladder, causing a lobulated impression usually seen with ovarian cysts. • Extension of a fibroid into the adjacent tissues may cause medial displacement of the pelvic ureter or ureteral compression leading to hydronephrosis.

  21. Leiomyomas (Uterine Fibroids) • Ultrasound shows a hypoechoic, solid contour-deforming mass in an enlarged inhomogenous uterus.

  22. Endometriosis • Most lesions are small and difficult to distinguish from normal tissue even when using modalities like CT and MRI. • This is the presence of normal appearing endometrium in sites other than their normal location inside the uterus. • Usually the ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum are most frequent, but the GI and Urinary tracts may also become affected.

  23. Endometriosis • Symptoms • Abdominal cramps, diarrhoea during menstruation and may appear either as single or multiple masses in the colon. • Endometriosis involving the urinary tract most commonly produces ureteral obstruction below the level of the pelvis brim.

  24. Cervical Cancer • May be detected in the early, curable stage by Pap test. • Increased manifestations may occur due to: • early age coitus, many sexual partners, genital herpes virus infections, poor obstetric and gynaecological care. • May be watery vaginal discharge or occasional spotting of blood.

  25. Cervical Cancer • Advanced lesions may have the following symptoms: • foul smelling vaginal discharge, leaking from bladder or rectal fistulas, anorexia, weight loss, back and leg pains.

  26. Cervical Cancer • Ultrasound usually demonstrates a cervical carcinoma as a solid echogenic mass behind the bladder.

  27. Cervical Cancer

  28. Cervical Cancer • CT is more accurate in detecting pelvic sidewall invasion and therefore is usually the initial staging procedure in patients in whom there is a clinical suspicion of advanced disease. • May show bladder invasion of carcinoma.

  29. Cervical Cancer

  30. Cervical Cancer

  31. Cervical Cancer • MRI can allow the cervix to be distinguished from the uterus and vagina.

  32. Cervical Cancer

  33. Endometrial Cancer • A malignant disease of the endometrium of the uterus • Most commonly occurs in the 5th or 6th decade of life. • Abnormal vaginal bleeding is the most common sign especially in a post menopausal woman • Endometrial lesions may invade the cervix but rarely the vagina.

  34. Endometrial Cancer • Typical Ultrasound appearance is an enlarged uterus with irregular areas of low-level echoes and bizarre clusters of high-intensity echoes.

  35. Endometrial Cancer

  36. Endometrial Cancer • CT demonstrates focal or diffuse enlargement of the body of the uterus.

  37. Endometrial Cancer

  38. Endometrial Cancer • MRI allows differentiation of the endometrium (inner layer) from the myometrium (muscle layer) of the uterus and has been useful in demonstrating focal or diffuse endometrial tumours.

  39. Endometrial Cancer

  40. Ovarian Cancer • Asymptomatic in early stages and therefore it is often not detected until it has metastasised. • Cystadenocarcinoma of the ovary often shows on ultrasound examination as a large cystic mass with internal septa. • Difficult to distinguish from Cystadenoma. • They often calcify.

  41. Ovarian Cancer

  42. Ovarian Cancer

  43. Ovarian Cancer

  44. Disorders of the Male Reproductive System Penis Scrotum Testis Epididymis

  45. Disorders of the Penis • Phimosis • condition where the foreskin cannot be pulled back because it is too tight

  46. Phimosis

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