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By:

Aduntatham, Natanicha
Allego, Marika
Artkla, Chanidaporn
Abbas, Princess Ameerah
Andalahao, Edzelle Marie
Aparece, Catherine Grace
Banaay, Anacleto Clent
Bernardo, Mary Grace
Beldua, fiona Therese
Cagoco, Kaye Sahara
 33 YEARS OLD WOMAN
 Menarche: age 12
 Coitarche: age 15
 Menstruation: Regular
 No pelvic exam for 5 years
 No birth Control
 Cervical exam: A Friable, Vascular Lesion on
the Anterior Cervix
 PAP smear: HGSIL
 Biopsy: Severe dysplasia (CIN III) with
Condyloma
 MIFT: (+) Chlamydia trachomatis
 Infertility
 Coitarche: age 15

 Friable, Vascular lesion

 High
Grade squamous intraepithelial lesion
(HGSIL)

 CIN III with Flat Condyloma

 (+) Chlamydia trachomatis infection


 ETIOLOGY OF
INFERTILITY

VULVAR/ UTERUS OVARIAN


CERVICAL
VAGINAL & IN ORIGIN
ORIGIN
ORIGIN ENDOMETRUIM

SQUAMOUS POLYCYSTIC
PELVIC CHRONIC
CELL OVARIAN
INFLAMMATOR ENDOMETRIOSIS
CARCINOMA DISEASE
Y DISEASE

CONDYLOMA
ACUMINATUM
PELVIC INFLAMMATORY DISEASE
CONDYLOMA ACCUMINATUM
SQUAMOUS CELL CARCINOMA
CHRONIC ENDOMETRITIS
- It is a disorder characterized by Pain, adnexal
tenderness, fever and vaginal discharge
- It resulted from either gonococcal, Chlamydia,
and or enteric bacterial infection
- No. 1 cause of PID: Chlamydia

Morphology:
-characterized by an Acute suppurative rxn. With
Inflammation confined to the superficial mucosa
and submucosa,
 inflammation usually begins in the Bartholin gland
and other vestibular glands or periurethral Glands.

 Infection ascends involving the tubes and the


tubolo-ovarian region except the Endometrium

Complication:
Peritonitis
Intestinal obstruction
Bacteremia
Infertility
- A sexually Transmitted Benign tumors involving
the perineal, vulvar, perianal regions, vagina
and less commonly the CERVIX.
- the most easily recognized sign of genital HPV
infection
- A wartlike (Verrucous) condition of the VULVA
occur in 3 forms:
- 1. Papilloma virus induced Condyloma
- 2. Mucosal polyps
- 3. Syphilitic condyloma latum
-Primarily caused by HPV type 6 and 11
- Associated with Benign genital lesions and
replicate in the squamous epithelium
- Does not Progress to Precancerous lesion
except in immunocompromized individuals.

Morphology:
Acanthosis, Parakeratosis, hyperkeratosis,
Nuclear Atypia with Perinuclear vacuolation.
- An invasive Carcinoma of the cervix
- Risk Factors:
Early Age of First intercourse
Multiple Sexual partners
Increase Parity
Male partner with Multiple sexual partners
Presence of Cancer-Associated HPV (70%)
exposure to oral contraceptives and
Nicotine
Genital Infections ( Chlamydia)
Squamous Cell Carcinoma may occur at any
age from the second decade of life to
senility.

Peak incidence: 40 to 45 – Invasive cancer


about 30 years – high grade
precancer.
Morphology:
3 distinct patterns
1. Fungating or exophytic
2. Ulcerating
3. Infiltrative

-Neoplastic mass projecting above the mucosa

-95% of Squamous Carcinomas are composed of


Relatively large cells either Keratinizing or
Non-keratinizing patterns.
<5% are Poorly differentiated Small cell or
undifferentiated carcinoma.
Stage 0- Carcinoma in Situ (CIN III)
Stage 1- Confined in the Cervix
Stage II- Extension beyond the cervix but not
onto the pelvic wall.
Stage III- Extension onto the Cervix wall
Stage IV- Extension beyond the cervix wall,
involving the mucosa of the bladder or
rectum
Occurs in:
1. Patients with chronic PID
2. Patients with Postpartal or postabortal
endometrial cavities
3. Patients with Intrauterine contraceptive
devices
4. Patients with Tuberculosis ( miliary or
tuberculous salpingitis)
- Non specific Chronic endometritis is
associated with Bleeding, pain, discharge
and INFERTILITY

- Chlamydia may be involved


PATHOLOGIC
CORRELATION

Lesion at the
INFERTILITY
Anterior Cervix

INFECTION
PELVIC HPV
INFLAMMATORY INFECTION
Dis.

HGSIL, CIN
CONDYLOMA
CHLAMYDIA ACUMINATUM

SQUAMOUS CELL
CARCINOMA
CLINICO-PATHOLOGIC
CORRELATIONS

Due to(+) Presence of Flat


INFERTILITY
Chlamydia Condyloma
trachomatis

Rule in PID HPV

Rule in Condyloma
Rule in
acuminatum
Chronic
endomitritis
+ HGSIL Regular Location of Lesion is
CIN III Menstruation CERVIX

RULE out Chronic Rule out out


+ HPV Endomitritis Chronic
Endomitritis

Early Rule out Ovarian


Coitarche Cystic disease

Multiple
sex partner

RULE IN
Squamous Cell
Carcinoma
Relationship of Pertinent findings

No abnormal
Infertility due to The presence of Menstrual cycle
Chlamydia Flat condyloma is
trachomatis due to HPV Vascular lesion at
infection infection the Anterior cervix

May cause Pelvic Cervical Pathology


inflammatory disease

Within the Age group(33)

Early Coitarche (age 15)

Squamous Cell Carcinoma In


situ ( CIN III)