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Diseases of the female genital system and breast

Diseases of the female genital system and breast. Anatomy of female genital system. Diseases of female genital system. Diseases of the cervix Diseases of body of uterus Diseases of pregnancy Tumors of the ovary Diseases of the breast. Normal cervix. Normal cervix.

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Diseases of the female genital system and breast

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  1. Diseases of the female genital system and breast

  2. Anatomy of female genital system

  3. Diseases of female genital system • Diseases of the cervix • Diseases of body of uterus • Diseases of pregnancy • Tumors of the ovary • Diseases of the breast

  4. Normal cervix

  5. Normal cervix Squamocoluminar junction is the seat of most of the epithelial diseases that occur in the cervix

  6. Diseases of the cervix • Chronic cervicitis • Neoplasia of the cervix

  7. Chronic cervicitis Erosion of cervix

  8. Chronic cervicitis Nabothian cyst

  9. Cervical polyps

  10. Chronic cervicitis

  11. Diseases of the cervix • Chronic cervicitis • Neoplasia of the cervix

  12. Cervical intraepithelial neoplasia(CIN) Invasive carcinoma of the cervix Neoplasia of the cervix

  13. CIN CIN I CIN II CIN III

  14. Normal cervical squamous epithelium CIN I

  15. CIN II

  16. CIN III

  17. Risk factors for CIN and invasive carcinoma • Sexual intercourse • Early age at first intercourse(≤ 17 years old) • Smoking • Human papillomavirus (HPV 16, 18, 33) • HIV infection • Male factors

  18. Cervical intraepithelial neoplasia(CIN) Invasive carcinoma of the cervix Neoplasia of the cervix

  19. Invasive carcinoma of the cervix • Vast majority are squamous cell carcinomas • Arise from transformation zone • Preceded by CIN • Average is 50 years

  20. Cervical carcinoma (early microinvasion)

  21. Cervical carcinoma (early stage) Abnormal hardness of the cervix

  22. Cervical carcinoma ( late stage) Fungating ulcerated areas destroy the cervix

  23. Pap smear ( diagnostic cervical cytology)

  24. Invasive carcinoma of the cervix

  25. Clinical feature • Unscheduled vaginal bleeding • Leukorrhea • Painful coitus (dyspareunia) • Dysuria (advanced stage)

  26. The size and depth of invasion of the primary tumor The prescence and the extent of lymph node metastasis Prognosis

  27. Outline of female genital system • Diseases of the cervix • Diseases of body of uterus • Diseases of pregnancy • Tumors of the ovary • Diseases of the breast

  28. Diseases of body of uterus • Adenomyosis • Endometriosis • Endometrial hyperplasia • Tumors of the endometrium and myometrium

  29. Adenomyosis: growth of endometrium down into the myometrium Endometriosis: growth of endometrium outside the uterus Adenomyosis and endometriosis ovaries fallopian tubes round ligaments pelvic peritoneum

  30. Adenomyosis and endometriosis

  31. Adenomyosis

  32. Endometriosis (uterine serosa)

  33. “Chocolate” cyst of the ovary

  34. Menstrual abnormalities dysmenorrhea Cyclic pelvic pain Dysmenorrhea Dyspareunia (painful intercourse) Infertility(30% of cases) Clinical feature Adenomyosis Endometriosis

  35. Diseases of body of uterus • Adenomyosis • Endometriosis • Endometrial hyperplasia • Tumors of the endometrium and myometrium

  36. Endometrial hyperplasia • Occurs in the third and fourth decades • In response to estrogen stimulation • Functional uterine bleeding

  37. Endometrial hyperplasia

  38. Diseases of body of uterus • Adenomyosis • Endometriosis • Endometrial hyperplasia • Tumors of the endometrium and myometrium

  39. Tumors of the endometrium Tumors of the myometrium • Endometrial carcinoma • Leiomyoma and leiomyosarcoma

  40. Endometrial carcinoma • The most common cancer of the female genital tract • Mean age : 56 years (80% of women are postmenopausal)

  41. Hyperestrogenic state Obesity Diabetes Late menopause Prolonged use of estrogen Estrogen-secreting tumors Risk factors • Previous pelvic irradiation • Lower parity

  42. Endometrial carcinoma (early stage)

  43. Endometrial carcinoma

  44. Endometrial adenocarcinoma

  45. Clinical feature • Irregular bleeding • Postmenopausal bleeding • Blood-stained discharge

  46. Diagnosis of endometrial disease • Transvaginal ultrasonography • Hysteroscopy • Endometrial biopsy

  47. Tumors of myometrium • Leiomyoma and leiomyosarcoma

  48. Leiomyoma • Commonest tumor of all pelvic tumors (affect over half of all women over the age of 30) • Benign tumor • Arise from the smooth muscle cells in the myometrium

  49. Risk factors • Age: rare under 30 years. • Parity: more common in nulliparous and women with low fertility. • Genetic: often with a family history

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