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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Research and development in contraception has only limited interest in women over 35 years old, so we know little about safety, side effects, and effectiveness of contraceptives in this age group. In addition, clinical trials use healthy women which further limits our knowledge about contraceptives in women who have cardiovascular problems, diabetes, and liver conditions. Research does indicate, however, that women with high blood pressure should not take oral contraceptives (OCs) after the age of 35. It also shows that healthy and nonobese women over 35 who do not smoke and have no family history of cardiovascular disease before age 45 can take OCs with 30 mcg of ethinyl estradiol. Practitioners should provide these women with balanced and up-to-date information on the link between OCs and breast cancer and their apparent protective effect against endometrial cancer. The pregnancy rate for 35-39 year old married women using the diaphragm for at least 5 months stands at 1.1/100 women years. Contrary to popular belief, barrier methods can be harmful, e.g., urinary tract infections are more frequent in women who use the diaphragm than in those who do not. Women older than 35 should consider the condom because of its ability to reduce the risk of acquiring HIV or sexually transmitted diseases. Considerable research exists on women over 35 who use copper releasing IUDs. These IUDs are safe in women who do not have heavy menstrual bleeding. The levonorgestrel releasing IUDs are well tolerated in women over 35 since they reduce the amount and duration of menstrual bleeding. Besides users of these IUDs are less likely to have pelvic inflammatory disease and endometritis than those using copper releasing IUDs. Older women in developing countries often undergo hysterectomy for contraceptive purposes and because of heavy bleeding. Tubal ligation is a significant family planning method for older women in developing countries.
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PMID:Contraception after thirty-five. 131 37

Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy (3), and radical parametrectomy (1). Hysterectomy was initially performed for the following indications: invasive lesion missed on cone biopsy, 17; hemorrhage at cone biopsy, 2; bleeding, 16; abnormal cytology, 13; presumed endometrial cancer, 9; known cancer, 7; pelvic relaxation, 5; planned therapy, 3; fibroids, 3; adnexal mass, 2; chronic discharge, 1; pyometra, 1; postpartum endometritis, 1. The cumulative 5-year survival for all patients was 68%, for squamous cell 80%, and for adenocarcinoma 41% (P = 0.0001). On postoperative evaluation 84 patients had presumed Stage I and 7 had parametrial involvement (Stage II). Patients with Stage I disease were then examined separately by cell type. Fifty-seven patients with squamous cell disease had cumulative 5-year survival of 85%. Radiation therapy in the immediate postoperative period produced a survival of 88%, compared to observation only with a 69% survival (P = .10). Patients with squamous cell disease and more than 50% cervical invasion had a 75% survival compared to a 96% survival for those with less than 50% (P = .02). The presence of disease at the surgical margins, grade, age, and increase in radiation therapy did not influence survival. Twenty-seven patients with presumed Stage I adenocarcinoma had a cumulative 5-year survival rate of 42%. Survival was significantly influenced by tumor grade (P = .018) and the amount of postoperative radiation therapy (P = .03), while age, amount of residual tumor, and presence of tumor at surgical margins did not influence survival. Patients with invasive squamous cell carcinoma treated by standard hysterectomy and postoperative radiation therapy have a prognosis similar to those treated initially by either radical surgery or radiation therapy. Patients with adenocarcinoma appear to have a significantly decreased survival when compared to patients with squamous cell disease and their prognosis is related to tumor grade and the amount of postoperative pelvic radiation.
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PMID:Invasive cervical cancer treated initially by standard hysterectomy. 229 56

Structural, functional, and morphological parameters of the endometrium were examined during and after long-term intrauterine contraception. The study included 638 women, aged 19-48, who had been using a Lippes' Loop for .4-12 years; the control group consisted of 96 women who were planning to use intrauterine contraception. Endometrial samples were treated with a 10% formalin solution, histologically processed, and embedded in paraffin. The sections were stained with a hematoxylineosin reagent using the van Gieson method. In 474 women using IUDs, no pathological changes of the endometrium were observed. IUDs did not cause atypical hyperplasia or cancer of the endometrium. Thus, the study shows that in most women using IUDs, the condition of the uterine mucosa was normal. Long-term (over 60 months), continuous IUD use increased the occurrence of some pathological changes of the endometrium, including chronic nonspecific endometritis, focal fibrosis of stroma, and atrophic changes of the mucosa. It is concluded that the clinical symptoms observed during long-term IUD use lack specificity and do not reflect deep morphological changes of the endometrium.
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PMID:[Status of the uterine mucosa during long-term intrauterine contraception]. 372 13

Of 332 patients for whom endometrial biopsy was indicated, vacuum curettage by the Vabra method was performed on 296 (89%) women as an outpatient procedure without anesthesia. The age range was 23-71 years, with a mean of 45.7. Material sufficient for histological diagnosis was obtained in 276 (93.3%), 7 (2.4%) of whom had endometrial cancer, 14 (4.7%) who had adenomatous hyperplasia, and 29 (9.8%) who had cystic hyperplasia. Of the 20 patients in whom the curettings could not be assessed, subsequent conventional curettage showed postmenopausal mucosa in 12 cases, endometrial polyps in 4, and atrophic mucosa due to the oral contraceptive pill in 4. 47 (15.8%) and 7 (2.3%) patients experienced moderate and severe pain respectively, and 2 (0.6%) had a vasovagal reaction. There was 1 case (0.3%) of endometritis and 6 (2%) of postoperative bleeding. During a follow-up period of 1-5.5 (mean 2.4) years, 16 patients have developed bleeding again, but repeated vacuum curettage disclosed benign conditions in all, with no endometrial cancer apart from the cases diagnosed primarily. Vacuum curettage is a quick, simple, and cheap method for histological diagnosis of endometrial tissue. It does not require anesthesia, patient acceptability is high, and reliability is satisfactory.
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PMID:Vacuum curettage by the Vabrar method. A simple procedure for endometrial diagnosis. 714 13

Endometrial cytology has been studied for more than 25 years, and a variety of cytologic devices have been developed for direct sampling of the endometrium. The quality of endometrial samples procured by various devices is markedly different and greatly affects the diagnostic accuracy. A new endometrial sampling device, the IUMC Endometrial Sampler, was developed at the Indiana University Medical Center and approved by the Food and Drug Administration for general medical use. This device is intended for the early detection of endometrial carcinoma and its precursors. It can be used to monitor the endometrial condition of patients receiving estrogen replacement therapy or tamoxifen. It is also useful for the procurement of uncontaminated endometrial samples for microbiologic studies from patients with suspected endometritis. It has the potential to be used for endometrial dating for patients with infertility disorders. In our clinical trials and sampling tests using hysterectomy specimens, adequate and representative endometrial samples without contamination from endocervix and vagina were consistently obtained by this device. The procedure of endometrial sampling using this device and the preparation techniques for endometrial brushing specimens are discussed and illustrated.
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PMID:Direct intrauterine sampling: the IUMC Endometrial Sampler. 925 25

Silver nucleolar organizer region (AgNOR) staining was employed in one hundred specimens of endometrium. These included fifteen normal controls (Proliferative + Secretory endometrium) and eighty five lesions. Endometrial lesions comprised of endometritis (15), endometrial hyperplasia (25) and endometrial carcinoma (45). Three micron thick sections of paraffin embedded tissue were subjected to AgNOR staining as described by Crocker and Smith with a little modification of 0.01% safranin counterstain--The mean AgNOR scores were found to increase steadily from normal to endometritis to endometrial hyperplasia and carcinoma--The observations revealed statistically significant differences in values between atypical hyperplasia and carcinoma also. AgNOR staining and scoring is simple, inexpensive and a useful adjunct to routine histopathology to evaluate endometrial lesions especially to differentiate borderline lesions. Though scores cannot be standardized and fixed for a particular lesion as there are intralaboratory variations.
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PMID:AgNORs in endometrial lesions. 1112 77

Xanthomatous changes are unusual lesions of the corpus endometrium that may mask endometrial carcinoma. The term "xanthomatous endometritis" refers to morphological changes frequently induced by estrogen stimulation. We report for the first time a case of uterine metastasis of balloon-cell melanoma mimicking xanthomatous endometritis. Light microscopic, immunohistological, and ultrastructural results are presented and discussed in connection with our ideas on the pathogenesis of this peculiar tumor. The findings favor the hypothesis of a regressive phenomenon in the balloon-cell transformation of melanoma cells. The melan-A immunohistology seems to be more important in the diagnosis of balloon cell melanoma than the classic melanoma antibody HMB 45.
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PMID:[Endometrial metastasis of a "balloon" cell melanoma mimicking a "xanthomatous endometritis"]. 1132 31

Of 900 biopsies made with a small suction curet 457 from 329 women were analyzed to show the progression of the endometrium from the high-estrogen early-proliferative phase, immediately following menstruation, through the late proliferation occurring about Day 12 foll owing menstruation. Classifications from Days 14 to 27 are much easier to make because the 1st sign of progestin effect causes significant change. On Day 15 vacuolization of the cytoplasm and beginning migration of the nuclei toward the surface of the cells is seen, leaving a lucid zone underlying the nuclei. On Day 17 this zone is well-marked and the nuclei above it are lining up to lie later each beside the other near the middle of the cell. On Day 19 the row of nuclei has sunk distally near to the base of all the cells. On Day 18 a beginning edema of the stroma is seen, first in patches; by Day 21 it is generalized and the last vestige of the zona pellucida has disappeared. On Day 21 the process of secretion, which began about Day 17, is well advanced. From Day 21 on the signs of hormonal action are seen not primarily in the gla nds but in the stroma and vascular system. Edema has become generalized by Day 21; on Day 23 the stroma cells are larger, more thick-walled, and more numerous; by Day 25 the edema is replaced by masses of contiguous large cells with large pale nuclei and much cytoplasm; and on Day 26 size of the stroma cells has extended so that almost all the interglandu lar cells are contiguous. On Day 27 this solidification of the most sup erficial stroma becomes complete, the glands are widely dilated, the epithelium approaches the cuboidal, the vascular system is highly developed, and the arterioles and venules are engorged with blood. Late on Day 27, just before menstruation, lymphocytes and polymorphonuclear leukocytes appear in great numbers and erythrocytes appear in clumps. T he whole predeciduum is infiltrated, the stroma nuclei become pale, neutrophils appear in large numbers, the tissue disintegrates, and menstruation occurs. Understanding of this normal process can aid in clinical diagnosis of menstrual disorders. A series of biopsies taken with a small surgical curet does little tissue damage and can reveal hormonal imbalance, thin stroma associated with menopause or hypoplastic endometrium, and such pathological conditions as tuberculous endometritis and cancer of the endometrium. In the 3 cases in which a woman with unsuspected early pregnancy was biopsied, no harm was done. This study showed amenorrhea is usually due to deficient follicular development but may be present even if a proliferative endometrium shows a high degree of follicle activity; in the absence of pregnancy there is never a persistent corpus aluteum.
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PMID:Biopsy studies of human endometrium: criteria of dating and information about amenorrhea, menorrhagia, and time of ovulation. 1225 49

Endometrium is a tissue which is in permanent changes in the active gynaecological period of a female. This can be followed-up through histological, custological and histochemical changes. In determining the morphologic changes and disturbances in endometrium, pathohistological examinations were and still are necessary and irreplaceable in defining the real causes of this phenomenon. The aim of our work is to show the pathohistological results of the material obtained by explorative curettage in metrorrhagia, to determine the aetiology of the pathological process in endometrium, which provokes irregular bleeding, and to check the possible increase in precancerogenic and malignant endometrial conditions over a period of three years. The examinations covered 786 patients who asserted that bleeding was the main symptom of their illness. In all of them explorative curettage was performed mainly in diagnostic and often in therapeutic purposes. The number of examinations are in constant increase. The age of the largest number of patients was from 41 to 50 years, a period when the anovulary cycle is most frequent which, in turn, causes changes in endometrium which results in irregular bleeding i.e. in metrorrhagia (Tables 1, 2 and 3). The most frequent histopathological changes were manifested by adenomatic hyperplasia (160), then glandular (136) and cystic hyperplasia (92). Eleven cases of endometrial carcinoma were detected. In two of these patients the finding was not confirmed by pathohistological result after the operation or repeated explorative currettage. In 64 patients atypical hyperplasia i.e. Ca in situ was found. Acute endometritis followed by irregular bleeding was observed during inflammatory process of the internal genital organs. In 35 patients chronic endometritis was found after curettage following the extraction of the intrauterine device (in one case after 40 years of carrying). In 103 patients with hyperplasia myomatous changes were noted; this finding correlated with hyperoestrogenism, which is usually present in both disorders. All authors agree that pathohistological examination of endometrium is the most reliable in the search for a correct diagnosis. Despite of all modern diagnostic and technical means, difficulties always arise in the assessment of malignant potential of endometrial hyperplasia. Therefore, the patients with recurrent bleeding caused by hyperplasia should be under intensive gynaecological control.
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PMID:[Results of histopathologic findings of endometrial changes in metrorrhagia]. 1275 Nov 62

A major proportion of the workload in many histopathology laboratories is accounted for by endometrial biopsies, either curettage specimens or outpatient biopsy specimens. The increasing use of pipelle and other methods of biopsy not necessitating general anaesthesia has resulted in greater numbers of specimens with scant tissue, resulting in problems in assessing adequacy and in interpreting artefactual changes, some of which appear more common with outpatient biopsies. In this review, the criteria for adequacy and common artefacts in endometrial biopsies, as well as the interpretation of endometrial biopsies in general, are discussed, concentrating on areas that cause problems for pathologists. An adequate clinical history, including knowledge of the age, menstrual history and menopausal status, and information on the use of exogenous hormones and tamoxifen, is necessary for the pathologist to critically evaluate endometrial biopsies. Topics such as endometritis, endometrial polyps, changes that are induced by hormones and tamoxifen within the endometrium, endometrial metaplasias and hyperplasias, atypical polypoid adenomyoma, adenofibroma, adenosarcoma, histological types of endometrial carcinoma and grading of endometrial carcinomas are discussed with regard to endometrial biopsy specimens rather than hysterectomy specimens. The value of ancillary techniques, especially immunohistochemistry, is discussed where appropriate.
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PMID:My approach to the interpretation of endometrial biopsies and curettings. 1687 62


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