••• Chapter 51^ Gynecologic Pathology^511
❍ What are some of the typical clinical signs and symptoms of endometriosis?
Dysmenorrhea, dyspareunia, pelvic pain, gastrointestinal abnormalities, and infertility. The disorder is most
common in women in their 20s and 30s.
❍ What is the most common tumor in women?
Leiomyoma (fibroids).
❍ What is the most reliable indicator of a leiomyosarcoma as opposed to a cellular leiomyoma?
The mitotic rate is used to differentiate them. Leiomyosarcomas will typically have a mitotic rate exceeding
10 mitotic figures per 10 high-power fields.
❍ Do most leiomyosarcomas arise from a preexisting leiomyoma?
No. Most believe that leiomyosarcomas arise de novo and that if they do arise within a preexisting leiomyomas,
that it is extremely rare (0.1%).
❍ How common is recurrence of leiomyosarcoma following resection?
Quite common, >50% of cases will metastasize hematogenously most commonly to the lungs.
❍ What is the typical histologic appearance of a benign endometrial polyp?
These are polypoid portions of endometrial mucosa containing both glands and stroma with thick-walled vessels.
❍ What is the most common bacteria associated with acute salpingitis?
Chlamydia trachomatis followed by Neisseria gonorrhoeae.
❍ How frequently are the fallopian tubes involved when there is tuberculosis involving the female genital
tract?
Essentially always.
❍ What are the histologic features of salpingitis isthmica nodosa?
This represents bilateral nodules typically in the tubal isthmus, which are composed of tubal epithelial lined
channels with admixed, prominent, and smooth muscle bundles.
❍ What are some risk factors for a tubal ectopic pregnancy?
A history of salpingitis isthmica nodosa, chronic salpingitis, and previous tubal pregnancy.
❍ What is the term given to describe small, simple cysts filled with clear serous fluid that occur commonly
next to the fallopian tubes?
Paratubal cysts, or when larger and near the fimbria, they are called hydatids of Morgagni.
❍ What benign mesothelial-derived tumor can occur in the fallopian tubes?
Adenomatoid tumor. This is the most common tumor of the epididymis.