Gynaecology knowledge: 205 conditions in gynaecology & obstetrics

Cervix & HPV

Adenocarcinoma in situ and adenocarcinoma of the cervix

Cervical adenocarcinoma in situ (AIS) is a pre-invasive lesion of the endocervical glandular epithelium and, because of its morphology, is regarded …

Cervix

Cervical cancer

The necessary factor: persistent infection with a high-risk HPV type — without HPV there is essentially no cervical cancer.

Cervix

Cervical dysplasia (CIN)

The TZ is the area between the original and the current squamocolumnar junction — through squamous metaplasia virtually every dysplasia arises there.

Cervix

Cervical polyp and ectropion

Typical presentation: contact bleeding and spotting, often an incidental finding.

Cervix

Cervical stenosis

Cervical stenosis is a narrowing or occlusion (stricture) of the internal cervical os.

Cervix

Cervicitis

Cervicitis is infectious or non-infectious inflammation of the cervical epithelium; the mucus-secreting columnar epithelium of the endocervix is …

Cervix

HPV infection

HPV infection is an infection of cutaneous or mucosal epithelial cells by human papillomaviruses.

Uterus & endometrium

Uterus

Asherman syndrome

Asherman syndrome denotes intrauterine adhesions arising after injury that destroys the basal layer of the endometrium.

Uterus

Endometrial cancer

FIGO I: Stage FIGO I means tumour confinement to the corpus uteri.

Uterus

Endometrial hyperplasia

Endometrial hyperplasia is an abnormal proliferation of endometrial glands with an increased gland-to-stroma ratio compared with proliferative endometrium.

Uterus

Endometrial polyp

Endometrial polyps are localised proliferations of endometrial glands, stroma and a central vascular core projecting into the uterine cavity, ranging …

Uterus

Haematometra and pyometra

Pyometra is a collection of pus in the uterine cavity resulting from impaired outflow through the cervix.

Uterus

Lynch syndrome in gynaecology

Pathophysiology: Lynch syndrome is based on a defect in DNA mismatch repair.

Uterus

Postmenopausal bleeding

Principle: Any bleeding after menopause is considered requiring workup until cancer is excluded.

Uterus

Uterine fibroids (leiomyoma)

Definition: A fibroid is a benign tumour of smooth muscle cells and connective tissue of the myometrium.

Uterus

Uterine malformations (septate, bicornuate uterus)

Congenital uterine anomalies result from abnormal formation, canalisation or fusion of the Müllerian ducts or from defective resorption of the …

Uterus

Uterine sarcoma (leiomyosarcoma)

Uterine sarcomas are rare malignant mesenchymal tumours of the uterus; leiomyosarcoma arises from smooth muscle cells or their mesenchymal precursors.

Endometriosis & adenomyosis

Endometriosis

Adenomyosis

Definition: Adenomyosis is defined as glands/stroma in myometrium with muscle hyperplasia.

Endometriosis

Chronic pelvic pain

Chronic pelvic pain is persistent or cyclically recurring, disabling pain in the pelvis; depending on the definition, a duration of at least 3 to 6 …

Endometriosis

Deep infiltrating endometriosis

Deep infiltrating endometriosis is present when endometriotic tissue with fibrosis and hyperplasia infiltrates more than 5 mm beneath the peritoneum; …

Endometriosis

Endometrioma (chocolate cyst)

An endometrioma is an endometriotic cyst of the ovary, also called a chocolate cyst because of its old blood content.

Endometriosis

Endometriosis is defined as ectopic endometrium-like tissue.

Ovary & adnexa

Adnexal torsion (ovarian torsion)

Symptomatology: Typical is sudden, severe, unilateral pain with nausea and vomiting, often wave-like.

Ovary & adnexa

Borderline ovarian tumour

Definition: A borderline tumour is an epithelial tumour with cellular atypia and proliferation, but without destructive stromal invasion.

Ovary & adnexa

Corpus luteum cyst and haemorrhagic ovarian cyst

When the corpus luteum fails to regress, a luteal cyst develops that may contain fluid or blood; the terms corpus luteum cyst and haemorrhagic corpus …

Ovary & adnexa

Fitz-Hugh-Curtis syndrome

Fitz-Hugh-Curtis syndrome is a perihepatitis in the setting of pelvic inflammatory disease: inflammation of the liver capsule without involvement of …

Ovary & adnexa

Granulosa cell tumour and sex cord-stromal tumours

Granulosa cell tumours belong to the sex cord-stromal tumours and consist of granulosa cells, theca cells and fibroblasts in varying combinations.

Ovary & adnexa

Hydrosalpinx

A hydrosalpinx develops when distal or proximal tubal occlusion causes the fallopian tube to fill with fluid and distend.

Ovary & adnexa

Krukenberg tumour

Krukenberg tumour: The Krukenberg tumour is a bilateral ovarian metastasis with signet ring cells, most commonly from gastric cancer.

Ovary & adnexa

Mature cystic teratoma (dermoid cyst)

Mature cystic teratoma (dermoid cyst) is a benign germ cell tumour composed of tissues from all three germ layers; ectodermal tissue and sebaceous …

Ovary & adnexa

Meigs syndrome

Meigs syndrome denotes a benign ovarian tumour, classically a fibroma, with ascites and pleural effusion.

Ovary & adnexa

Ovarian cancer

FIGO I: FIGO stage I describes a tumour limited to the ovaries or fallopian tubes.

Ovary & adnexa

Ovarian cysts (adnexal cysts)

The follicular cyst is unilocular, anechoic, smooth-walled, and usually resolves within two to three cycles.

Ovary & adnexa

Ovarian germ cell tumours

Ovarian germ cell tumours arise from primitive germ cells; about 95% are benign mature cystic teratomas and only about 5% are malignant.

Ovary & adnexa

Pelvic inflammatory disease (PID)

The term covers: ascending infection of uterus, tubes, ovaries.

Ovary & adnexa

Peritoneal carcinomatosis of gynaecological origin

Peritoneal surface malignancies are tumours arising from or spreading to the peritoneum, including primary peritoneal tumours, pseudomyxoma peritonei …

Ovary & adnexa

Tubo-ovarian abscess

Tubo-ovarian abscess is a severe complication of pelvic inflammatory disease with adnexal inflammation, typically involving a pus-filled tube and …

Vulva & vagina

Anogenital warts (condylomata acuminata)

Anogenital warts (condylomata acuminata) are the clinical manifestation of a sexually transmitted infection with certain HPV types.

Vulva & vagina

Atrophic vaginitis

Atrophic vaginitis is part of the genitourinary syndrome of menopause (GSM), which comprises the genital, sexual and urinary changes resulting from …

Vulva & vagina

Bacterial vaginosis

Why it is not a true colpitis: few signs of inflammation, few leukocytes.

Vulva & vagina

Bartholin cyst and abscess

Location: The Bartholin's gland duct opens in the posterior third of the introitus, at approximately the 5 and 7 o'clock positions.

Vulva & vagina

Chlamydia infection

Genital chlamydia infection is a sexually transmitted infection with Chlamydia trachomatis, an obligate intracellular, Gram-negative bacterium.

Vulva & vagina

Female genital mutilation (FGM)

According to the WHO, female genital mutilation comprises all practices that partially or totally cut away the external female genitalia or otherwise …

Vulva & vagina

Genital herpes

Genital herpes is an infection with herpes simplex virus type 1 or 2 that presents as a primary or recurrent infection.

Vulva & vagina

Gonorrhoea

Gonorrhoea is a sexually transmitted infection with Neisseria gonorrhoeae, a Gram-negative diplococcus that primarily targets columnar and …

Vulva & vagina

Trichomoniasis

Route of transmission: sexual — it is a sexually transmitted infection.

Vulva & vagina

Vaginal intraepithelial neoplasia (VaIN) and vaginal cancer

Vaginal intraepithelial neoplasia (VaIN) is a rare precancerous lesion of the vaginal epithelium that is strongly associated with HPV and can …

Vulva & vagina

Vulvar cancer

Drainage pathways: The lymphatic drainage of the vulva proceeds first to the superficial and deep inguinofemoral lymph nodes, then onwards to the …

Vulva & vagina

Vulvar haematoma

A vulvar haematoma is a collection of blood in the vulva, which is supplied mainly by the pudendal artery.

Vulva & vagina

Vulvar intraepithelial neoplasia (VIN)

Nomenclature: HPV-dependent VIN is now referred to as vulvar HSIL or uVIN.

Vulva & vagina

Vulvar lichen planus

Vulvar lichen planus is a chronic autoimmune disease affecting the skin and mucous membranes, including the vulva and vagina.

Vulva & vagina

Vulvar lichen sclerosus

Definition: Lichen sclerosus is a chronic inflammatory, likely autoimmune-mediated dermatosis.

Vulva & vagina

Vulvar melanoma

Incidence: Vulvar melanoma is the second most common malignant tumour of the vulva.

Vulva & vagina

Vulvar Paget disease

Histology: Histologically, one finds large, pale, vacuolated Paget cells, singly and in nests within the epidermis.

Vulva & vagina

Vulvodynia

According to the ISSVD, vulvodynia is vulvar pain lasting at least 3 months without an identifiable cause, although potential contributing factors …

Vulva & vagina

Vulvovaginal candidiasis

Vulvovaginal candidiasis is inflammation of the vulva and vagina due to infection with Candida species, most commonly Candida albicans.

Endocrinology & cycle

Endocrinology

Abnormal uterine bleeding

How to assess the amount in practice: pad/tampon use, presence of clots.

Endocrinology

Amenorrhoea

Primary amenorrhoea: no menarche by 15 yrs, earlier if no puberty.

Endocrinology

Androgen insensitivity syndrome

Androgen insensitivity syndrome is a difference of sex development in individuals with a 46,XY karyotype caused by impaired androgen receptor …

Endocrinology

Congenital adrenal hyperplasia (CAH)

Congenital adrenal hyperplasia comprises a group of autosomal recessive enzyme defects of cortisol synthesis in the adrenal cortex; depending on the …

Endocrinology

Dysmenorrhoea

Dysmenorrhoea denotes pain of uterine origin around the time of menstruation; it is typically located in the midline of the lower abdomen and may …

Endocrinology

Female infertility

Age at which to start earlier: from age 35 (declining oocyte reserve).

Endocrinology

Functional hypothalamic amenorrhoea

Functional hypothalamic amenorrhoea is chronic anovulation with absent menses without any identifiable organic cause, resulting from disrupted …

Endocrinology

Hirsutism and hyperandrogenism

Hypertrichosis: androgen-independent hair growth, often drug-induced.

Endocrinology

Hyperprolactinaemia and prolactinoma

Definition of the size limit: microprolactinoma < 10 mm, macroprolactinoma ≥ 10 mm.

Endocrinology

Imperforate hymen and haematocolpos

Imperforate hymen is present when the hymen, a thin membrane of stratified squamous epithelium at the vaginal introitus, fails to rupture …

Endocrinology

Luteal phase deficiency

Follicular persistence: no ovulation, estrogen production persists.

Endocrinology

Mayer-Rokitansky-Küster-Hauser syndrome

Mayer-Rokitansky-Küster-Hauser syndrome is a congenital absence or underdevelopment of the uterus and upper vagina with a 46,XX karyotype, normal …

Endocrinology

Menopausal syndrome

Premature menopause (climacterium praecox): cessation of ovarian function before age 40.

Endocrinology

Ovarian hyperstimulation syndrome (OHSS)

Ovarian hyperstimulation syndrome is a potentially life-threatening iatrogenic complication of ovarian stimulation in which the ovaries become …

Endocrinology

Polycystic ovary syndrome (PCOS)

Second criterion: clinical and/or biochemical hyperandrogenism.

Endocrinology

Postmenopausal osteoporosis

Osteoporosis is a systemic skeletal disease with low bone mass and distorted microarchitecture, leading to increased fracture susceptibility; in the …

Endocrinology

Precocious and delayed puberty

Precocious puberty denotes the onset of secondary sexual characteristics in girls before the age of 8.

Endocrinology

Premature ovarian insufficiency (POI)

Premature ovarian insufficiency is a loss of ovarian function before the age of 40, with amenorrhoea, low oestradiol and raised FSH.

Endocrinology

Premenstrual syndrome (PMS/PMDD)

Premenstrual syndrome comprises mood, behavioural and physical symptoms that begin in the luteal phase about 1 to 2 weeks before menstruation and …

Endocrinology

Turner syndrome

Turner syndrome is a chromosomal disorder in individuals with a female phenotype who have one normal X chromosome while the second sex chromosome is …

Breast

B3 lesions of the breast

B3 lesions are breast lesions of uncertain malignant potential: a heterogeneous group with a borderline histological spectrum and a variable but low …

Breast

Breast abscess

Organised collection of inflammatory exudate, or pus, in the breast.

Breast

Breast cancer

Luminal A: A Luminal A carcinoma is hormone receptor-positive, HER2-negative, well-differentiated with a low Ki-67.

Breast

Ductal carcinoma in situ (DCIS)

Definition: Ductal carcinoma in situ (DCIS) is an intraductal neoplasia in which the basement membrane is intact, thus making metastasis impossible.

Breast

Fibroadenoma

A fibroadenoma is the most common benign breast tumour in young women, firm, well-circumscribed, and mobile.

Breast

Fibrocystic breast changes and breast cysts

The most common benign breast condition, now usually termed fibrocystic changes rather than disease; it reflects hormonally mediated remodelling of …

Breast

Galactorrhoea

Milk production from the breast unrelated to pregnancy or lactation; milk production one year or more after lactation has ended is also considered …

Breast

HER2-positive breast cancer

Breast cancer with amplification of the HER2 gene and/or overexpression of the HER2 protein, a transmembrane tyrosine kinase receptor of the HER …

Breast

Hereditary breast and ovarian cancer syndrome (BRCA)

Hereditary cancer predisposition syndrome caused by pathogenic germline variants in BRCA1 (long arm of chromosome 17) or BRCA2 (long arm of …

Breast

Hormone receptor-positive breast cancer (luminal A and B)

Hormone receptor-positive breast cancer with oestrogen and/or progesterone receptors, corresponding to the luminal A and luminal B molecular subtypes.

Breast

Inflammatory breast cancer

Clinicopathological entity of breast cancer with erythema and oedema over at least one third of the breast, classified as T4d in the TNM system.

Breast

Intraductal papilloma

Benign intraluminal proliferation within the breast ducts and the most common papillary lesion of the breast.

Breast

Lobular breast cancer and lobular neoplasia

Lobular breast lesions consist of small, noncohesive tumour cells arising from the lobules or the terminal duct lobular unit (TDLU).

Breast

Male breast cancer

Male breast cancer is rare: fewer than 1% of all breast cancers occur in men.

Breast

Non-puerperal mastitis

Inflammation of the breast arising independently of lactation, distinguished as nonlactational (non-puerperal) mastitis from the lactational …

Breast

Paget disease of the nipple

Eczema-like change of the nipple and areola caused by large intraepidermal carcinoma cells (Paget cells), associated in over 90% with underlying DCIS …

Breast

Phyllodes tumour

Rare biphasic fibroepithelial tumour of the breast with a morphological continuum from benign to malignant, accounting for 0.3–1% of primary breast …

Breast

Pregnancy-associated breast cancer

Breast cancer newly diagnosed during pregnancy, within a year of giving birth or at any time during lactation.

Breast

Triple-negative breast cancer

Definition: Triple-negative means: oestrogen receptor, progesterone receptor and HER2 are negative.

Pelvic floor & urogynaecology

Urogynaecology

Cystocele

Prolapse of the anterior vaginal wall in which the bladder protrudes into the vagina; if the urethra is also involved, it is called a cystourethrocele.

Urogynaecology

Female urinary incontinence

Stress incontinence: urine leakage on coughing, sneezing, lifting, or exercising, without a preceding urge to urinate.

Urogynaecology

Occult stress urinary incontinence

Definition: stress incontinence that only becomes apparent after the prolapse is corrected.

Urogynaecology

Overflow incontinence

Involuntary leakage of urine from an overdistended bladder due to reduced detrusor contractility or bladder outlet obstruction.

Urogynaecology

Pelvic organ prolapse

Anterior compartment: cystocele and urethrocele, i.e. the anterior vaginal wall with the bladder and urethra.

Urogynaecology

Rectocele and enterocele

A rectocele is a form of pelvic organ prolapse in which the rectum herniates through the rectovaginal septum into the posterior vaginal wall.

Urogynaecology

Stress urinary incontinence

Sudden involuntary leakage of urine during activities that raise intra-abdominal pressure, such as exertion, sneezing, coughing, laughing or straining.

Urogynaecology

Urge incontinence and overactive bladder

A sudden, compelling urge to void that is difficult to hold and often results in involuntary leakage of urine.

Urogynaecology

Urogenital fistulas (vesicovaginal fistula)

Abnormal communication between the bladder and the vagina resulting in continuous leakage of urine through the vagina.

Urogynaecology

Uterine prolapse

Descent of the uterus with the cervix towards or past the introitus; in women without a uterus the vaginal vault (cuff) can descend in the same way …

Early pregnancy

Caesarean scar pregnancy

Definition: implantation of the gestational sac in the caesarean scar of the lower uterine segment.

Early pregnancy

Cervical pregnancy

Cervical pregnancy is the implantation of the gestational sac in the endocervical canal below the internal os and a rare form of non-tubal ectopic …

Early pregnancy

Ectopic pregnancy

Ectopic pregnancy (EP) affects approximately 1 to 2% of all pregnancies.

Early pregnancy

Gestational trophoblastic neoplasia (choriocarcinoma)

Gestational trophoblastic neoplasia (GTN) comprises the malignant, non-molar forms of gestational trophoblastic disease: invasive mole, …

Early pregnancy

Heterotopic pregnancy

A heterotopic pregnancy is the simultaneous presence of an intrauterine and an extrauterine pregnancy.

Early pregnancy

Hydatidiform mole (gestational trophoblastic disease)

A distinction is made between partial and complete hydatidiform moles and gestational trophoblastic neoplasias, which include the invasive mole, …

Early pregnancy

Hyperemesis gravidarum

Hyperemesis gravidarum is the severe end of the spectrum of nausea and vomiting of pregnancy and is characterised by persistent vomiting, significant …

Early pregnancy

Interstitial (cornual) pregnancy

Interstitial pregnancy is an ectopic pregnancy in the interstitial segment of the fallopian tube, the part of the tube that crosses the uterine wall.

Early pregnancy

Miscarriage

A miscarriage is defined as the loss of a pregnancy before the foetus is viable, which is under 500 g weight.

Early pregnancy

Missed miscarriage

A missed miscarriage is a non-viable pregnancy without symptoms with a a closed cervix.

Early pregnancy

Ovarian pregnancy

Ovarian pregnancy is one of the rarest forms of ectopic pregnancy, with implantation in the ovary.

Early pregnancy

Pregnancy of unknown location (PUL)

A pregnancy of unknown location (PUL) is present when there is a positive pregnancy test and a measurable beta-hCG level, but an ultrasound scan …

Early pregnancy

Recurrent pregnancy loss

Common groups of causes include chromosomal, uterine, endocrine, immunological and thrombophilic and male factors.

Early pregnancy

Septic miscarriage

A septic miscarriage is an early pregnancy loss complicated by intrauterine infection; traditionally the term denotes any spontaneous or induced …