Benign Tumors Of The Cervix
Benign Tumors Of The Cervix
Endocervical polypsEndocervical polyps are the most common benign neoplasms of the cervix. Please note that the word neoplasm refers to a cancerous growth. They are focal hyperplastic (abnormal cell growth) protrusions of the endocervical folds, including the epithelium and substantia propria. They are most common in the fourth to sixth decades of life and usually are asymptomatic but may cause profuse leukorrhea or postcoital spotting. (blood after orgasm)Grossly, they appear as typical polypoid structures protruding from the cervical os. At times, endometrial polyps protrude through the cervical os. They cannot be distinguished from endocervical polyps by gross appearance. Microscopically, a variety of histologic patterns are observed, including
(1) typical endocervical mucosal
(2) inflammatory (granulation tissue)
(3) fibrous
(4) vascular
(5) pseudodecidual
(6) mixed endocervical and endometrial
(7) pseudosarcomatous.Treatment is removal, which can usually be accomplished by twisting the polyp with a dressing forceps if the pedicle is slender. Smaller polyps may be removed with punch biopsy forceps. Polyps with a thick stalk may require surgical removal.Microglandular hyperplasia
Microglandular hyperplasia refers to a clinically polypoid growth measuring 1-2 cm. It occurs most often in women who are on oral contraceptive therapy or Depo-Provera and in pregnant or postpartum women. It reflects the influence of progesterone.
Microscopically, it consists of tightly packed glandular or tubular units, which vary in size, lined by a flattened-to-cuboidal epithelium with eosinophilic granular cytoplasm containing small quantities of mucin. Nuclei are uniform, and mitotic figures are rare. Squamous metaplasia and reserve cell hyperplasia are common. An atypical form of hyperplasia can be mistaken for clear cell carcinoma. Unlike clear cell carcinoma, it lacks stromal invasion, has scant mitotic activity, and lacks intracellular glycogenSquamous papilloma
Squamous papilloma is a benign solid tumor typically located on the ectocervix. It arises most commonly as a result of inflammation or trauma.
Grossly, the tumors are usually small, measuring 2-5 mm in diameter. Microscopically, the surface epithelium may show acanthosis, parakeratosis, and hyperkeratosis. The stroma has increased vascularity and a chronic inflammatory infiltrate. Treatment is removal. The squamous papilloma resembles a typical condyloma acuminatum but lacks the koilocytes microscopically.Smooth muscle tumors (leiomyomas)
These benign neoplasms may originate in the cervix and account for approximately 8% of all uterine smooth muscle tumors. They are similar to tumors in the fundus. When located in the cervix, they usually are small, ie, 5-10 mm in diameter.
Symptoms depend on size and location. Microscopically, leiomyomas resemble the typical smooth muscle tumor found in the uterine corpus. Treatment is required only for those patients who are symptomatic. The cervical leiomyoma is usually part of the spectrum of uterine smooth muscle tumors.Mesonephric duct remnants
When present, mesonephric duct remnants are typically located at the 3-o'clock and the 9-o'clock positions, deep within the cervical stroma. They usually are incidental findings and are present in approximately 15-20% of serially sectioned cervices. As the name implies, mesonephric duct remnants are vestiges of the mesonephric or Wolffian duct. Usually, they are only a few millimeters in diameter and seldom are grossly visible.
Microscopically, they consist of a proliferation of small round tubules lined by epithelium that is cuboidal to low columnar. The tubules tend to cluster around a central duct. The cells lining the tubules contain no glycogen or mucin, but the center of the tubule may contain a pink material that contains glycogen or mucin.Endometriosis
When present in the cervix, endometriosis is usually an incidental finding. Grossly, it may appear as a bluish-red or bluish-black lesion, typically 1-3 mm in diameter. Microscopically, the implants are typical endometriosis, consisting of endometrial glands, endometrial stroma, and hemosiderin-laden macrophages. The implants usually gain access to the cervix during childbirth or previous surgery.Papillary adenofibroma
This neoplasm is uncommon. Grossly, it appears as a polypoid structure. Microscopically, the neoplasm contains branching clefts and papillary excrescences lined by mucinous epithelium with foci of squamous metaplasia. A compact, cellular, fibrous tissue composed of spindle-shaped and stellate fibroblasts supports the epithelium. The stroma is devoid of smooth muscle, and mitoses are rare. Similar growths occur in the endometrium and the fallopian tubes.Heterologous tissue
Heterologous tissue includes cartilage, glia, and skin with appendages. This type of tumor rarely occurs in the cervix. While they may arise de novo, these tumors probably represent implants of fetal tissue from a previous aborted pregnancy.
Hemangiomas
Hemangiomas in the cervix are rare in occurence and are similar to those found elsewhere in the body.Gregory Mburu us a medical professional and a part time marketr. He post information about breast cancer and other gynaecological neoplastic disorders at http://breast-cancer-information.blogspot.com/
?Ooohhh? my aching knee!!!? Insider Secrets on How You Can Get Relief Quickly and Easily!
?Ooohhh? my aching knee!!!? Insider Secrets on How You Can Get Relief Quickly and Easily!
When your knee hurts, getting relief is all that's on your mind. Getting the right relief, though, depends on knowing what's wrong. The correct diagnosis will lead to the correct treatment.Know Your Knee!The knee is the largest joint in the body. It's also one of the most complicated. The knee joint is made up of four bones that are connected by muscles, ligaments, and tendons. The femur (large thigh bone) interacts with the two shin bones, the tibia (the larger one) located towards the inside and the fibula (the smaller one) located towards the outside. Where the femur meets the tibia is termed the joint line. The patella, (the knee cap) is the bone that sits in the front of the knee. It slides up and down in a groove in the lower part of the femur (the femoral groove) as the knee bends and straightens.Ligaments are the strong rope-like structures that help connect bones and provide stability. In the knee, there are four major ligaments. On the inner (medial) aspect of the knee is the medial collateral ligament (MCL) and on the outer (lateral) aspect of the knee is the lateral collateral ligament (LCL). The other two main ligaments are found in the center of the knee. These ligaments are called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). They are called cruciate ligaments because the ACL crosses in front of the PCL. Other smaller ligaments help hold the patella in place in the center of the femoral groove.Two structures called menisci sit between the femur and the tibia. These structures act as cushions or shock absorbers. They also help provide stability for the knee. The menisci are made of a tough material called fibrocartilage. There is a medial meniscus and a lateral meniscus. When either meniscus is damaged it is called a "torn cartilage".There is another type of cartilage in the knee called hyaline cartilage. This cartilage is a smooth shiny material that covers the bones in the knee joint. In the knee, hyaline cartilage covers the ends of the femur, the femoral groove, the top of the tibia and the underside of the patella. Hyaline cartilage allows the knee bones to move easily as the knee bends and straightens.Tendons connect muscles to bone. The large quadriceps muscles on the front of the thigh attach to the top of the patella via the quadriceps tendon. This tendon inserts on the patella and then continues down to form the rope-like patellar tendon. The patellar tendon in turn, attaches to the front of the tibia. The hamstring muscles on the back of the thigh attach to the tibia at the back of the knee. The quadriceps muscles are the muscles that straighten the knee. The hamstring muscles are the main muscles that bend the knee.Bursae are small fluid filled sacs that decrease the friction between two tissues. Bursae also protect bony structures. There are many different bursae around the knee but the ones that are most important are the prepatellar bursa in front of the knee cap, the infrapatellar bursa just below the kneecap, the anserine bursa, just below the joint line and to the inner side of the tibia, and the semimembranous bursa in the back of the knee. Normally, a bursa has very little fluid in it but if it becomes irritated it can fill with fluid and become very large.Is it bursitis... or tendonitis...or arthritis?Tendonitis generally affects either the quadriceps tendon or patellar tendon. Repetitive jumping or trauma may set off tendonitis. The pain is felt in the front of the knee and there is tenderness as well as swelling involving the tendon. With patellar tendonitis, the infrapatellar bursa will often be inflamed also. Treatment involves rest, ice, and anti-inflammatory medication. Injections are rarely used. Physical therapy with ultrasound and iontopheresis may help.Bursitis pain is common. The prepatellar bursa may become inflamed particularly in patients who spend a lot of time on their knees (carpet layers). The bursa will become swollen. The major concern here is to make sure the bursa is not infected. The bursa should be aspirated (fluid withdrawn by needle) by a specialist. The fluid should be cultured. If there is no infection, the bursitis may be treated with anti-jnflammatory medicines, ice, and physical therapy. Knee pads should be worn to prevent a recurrence once the initial bursitis is cleared up.Anserine bursitis often occurs in overweight people who also have osteoarthritis of the knee. Pain and some swelling is noted in the anserine bursa. Treatment consists of steroid injection, ice, physical therapy, and weight loss.The semimembranous bursa can be affected when a patient has fluid in the knee (a knee effusion). The fluid will push backwards and the bursa will become filled with fluid and cause a sensation of fullness and tightness in the back of the knee. This is called a Baker's cyst. If the bursa ruptures, the fluid will dissect down into the calf. The danger here is that it may look like a blood clot in the calf. A venogram and ultrasound test will help differentiate a ruptured Baker's cyst from a blood clot. The Baker's cyst is treated with aspiration of the fluid from the knee along with steroid injection, ice, and elevation of the leg.Knock out knee arthritis... simple steps you can take!
Younger people who have pain in the front of the knee have what is called patellofemoral syndrome (PFS). Two major conditions cause PFS. The first is chondromalacia patella. This is a condition where the cartilage on the underside of the knee cap softens and is particularly common in young women. Another cause of pain behind the knee cap in younger people may be a patella that doesn't track normally in the femoral groove. For both chondromalacia as well as a poorly tracking patella, special exercises, taping, and anti-inflammatory medicines may be helpful. If the patellar tracking becomes a significant problem despite conservative measures, surgery is need.While many types of arthritis may affect the knee, osteoarthritis is the most common. Osteoarthritis usually affects the joint between the femur and tibia in the medial (inner) compartment of the knee. Osteoarthritis may also involve the joint between the femur and tibia on the outer side of the knee as well as the joint between the femur and patella. Why osteoarthritis develops is still being scrutinized carefully. It seems to consist of a complex interaction of genetics, mechanical factors, and immune system involvement. The immune system attacks the joint through a combination of degradative enzymes and inflammatory chemical messengers called cytokines.Patients will sometimes feel a sensation of rubbing or grinding. The knee will become stiff if the patient sits for any length of time. With local inflammation, the patient may experience pain at night and get relief from sleeping with a pillow between the knees. Occasionally, locking and clicking may be noticed. Patients with osteoarthritis may also tear the fibrocartilage cushions (menisci) in the knee more easily than people without osteoarthritis.So how is the arthritis treated? An obvious place to start is weight reduction for patients who carry around too many pounds.Strengthening exercises for the knee are also useful for many people. These should be done under the supervision of a physician or physical therapist.Other therapies include ice, anti inflammatory medicines, and occasionally steroid injections.
Glucosamine and chondroitin supplements may be helpful. A word of caution... make sure the preparation you buy is pure and contains what the label says it does. The supplement industry is unregulated... so buyer beware!Injections of the knee with viscosupplements ? lubricants- are particularly useful for many patients. Special braces may help to unload the part of the joint that is affected.Arthroscopic techniques may be beneficial in special circumstances. Occasionally, a surgical procedure called an osteotomy, where a wedge of bone is removed from the tibia to "even things out," may be recommended. Joint replacement surgery is required for end stage knee arthritis.Research is being done to develop medicines that will slow down the rate of cartilage loss. Targets for these new therapies include the destructive enzymes and/or cytokines that degrade cartilage. It is hoped that by inhibiting these enzymes and cytokines and by boosting the ability of cartilage to repair itself, that therapies designed to actually reverse osteoarthritis may be created. These are referred to as disease-modifying osteoarthritis drugs or "DMOADs." Genetic markers may identify high risk patients who need more aggressive therapies.Newer compounds that are injected into the knee and provide healing as well as lubrication are also being developed. And finally, less invasive surgical techniques are also being looked at. Recent technological advances in "mini" knee replacement look very promising.Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. Dr. Wei is the editor of the arthritis-treatment-and-relief.com website.
Over The Counter Drugs: How To Safely Choose The Right Medication
Over The Counter Drugs: How To Safely Choose The Right Medication
What Medication Can Cure Me?1. Am I expecting a cure? Some medications relieve symptoms ? that is, they stop the itching, pain, redness, etc ? but do not actually get to the source of the illness. Some illnesses, like the common cold, can't be treated/cured, so looking for an OTC drug may be a waste of time; getting rest and drinking fluids may be a better way to spend your afternoon! Other things, like yeast infections, can be treated by over the counter medications; if the infection is making you uncomfortable as well as needing treatment, make sure that you pick a product that gives you both symptomatic relief and treatment.Is It Safe For Your Child?2. Is it for your child? If so make sure that you're getting a drug that can be given to children. Some drugs that help adults can be dangerous for children; others need to be given at a special dosage. Read the fine print on the box before buying for your child.What About Interactions With Other Drugs?3. What else am I taking? If you're on any other medications, whether over-the-counter or prescription, stop by the pharmacist's desk before heading to the check-out counter. She can check to make sure that the drugs you are taking don't change the effect of the drugs you are taking.Wait... Shouldn't My Illness Be Over Already?4. Should my illness have ended by now? If you think you have something that has a natural lifecycle - that is, something like a cold that should end on its own - but you don't feel better after that time is up, you may have misdiagnosed your illness. If you're having to take pain-reliever nonstop to keep functioning, your body is trying to tell you something and you should listen. What feels like a cold might be bronchitis; that achy foot may require orthotics, not aspirin.Long Term Medication Use5. Is it a chronic problem? If you're having to take over-the-counter medications over a long period of time to prevent symptoms, it is time for your health care practitioner to find out what the underlying cause is. Even something as simple as scaly skin may be a warning sign that you're developing diabetes. And some relatively harmless medications can have serious long-term consequences; for example, some over the counter pain medications can cause stomach bleeding if you take them for a long time. If you're taking an OTC medication constantly to reduce long-term discomfort, talk to your health care provider to make sure that a) you're not missing something important and b) that if it's a chronic problem, you're taking medication that your body can handle chronically.Compare Ingredients6. What's the active ingredient? If the same active ingredient is found in both the name brand and the generic, chances are they will have the same effect.Pregnant Or Breast Feeding?7. If you're pregnant or nursing, check with your physician before taking ANY medication, including OTC drugs and alternative products (such as herbal remedies). Some drugs can cross the placenta or through the milk glands, giving your fetus or baby a whopping dose of medication. While the medication might be fine for you, it may not be fine for your baby.Watch Out For Alcohol8. Does the medication contain alcohol? If it does, it's probably going to make you sleepy, it will probably make you feel dehydrated, and adding more alcohol on top of it can be dangerous.Double-Doses: Be Careful!9. Am I doubling up? If you're taking more than one over-the-counter medication, make sure that they don't have the same ingredients; if they do, you might be doubling the recommended dose of that medication and setting yourself up for unpleasant side effects. This is a particular problem when you take something that combats multiple symptoms of an illness (like "flu" medications that relieve pain, fever, stuffy nose, and sore throat) - often they contain multiple active ingredients, one of which may overlap with another medication (like a pain killer) that you're takingSide Effects And Allergies10. Check the label for side effects and symptoms of allergic reaction. If side effects include drowsiness and you drive a truck or care for several active toddlers, this medication might not be right for you. Similarly, if you start running a fever or develop a rash, having read the label ahead of time will help you know if you need to stop the medication and call a doctor to avert a full-blown allergic attack.Copyright (C) Shoppe.MD and Ian Mason, 2004-2005Ian Mason, owner of Shoppe.MD, your source for Online Prescription Medications, drug information and support forums.Ian is a fat-to-fit student of health, weight loss, exercise, and several martial arts; maintaining several websites in an effort to help provide up-to-date and helpful information for other who share his interests in health of body and mind.