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The Reproductive System. MIS311 Imaging Pathology 2 Prepared by S. Beatty 1998. The Reproductive System. Infection and Inflammation Benign Growth & Proliferative Growth Female Infertility Disorders of the Male Reproductive System Disorders of the breast.

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The Reproductive System

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The reproductive system

The Reproductive System

MIS311 Imaging Pathology 2

Prepared by S. Beatty 1998

The reproductive system1

The Reproductive System

  • Infection and Inflammation

  • Benign Growth & Proliferative Growth

  • Female Infertility

  • Disorders of the Male Reproductive System

  • Disorders of the breast

Infection inflammation pelvic inflammatory disease pid

Infection & InflammationPelvic Inflammatory Disease (PID)

  • Any inflammatory condition of the female pelvic organs.

  • Usually caused through bacterial infection

  • Symptoms include:

    • fever, foul-smelling vaginal discharge, lower abdominal pain, pain with coitus.

    • If an abscess has developed then a fluid-filled mass may be palpated.

The reproductive system


  • Fibrosis associated with PID may cause uterine tube blockage  infertility.

  • Ultrasound is often used with diagnosis of PID and associated pelvic abscesses.

  • Hysterosalpingogram is still performed in checking uterine tube patency.

The reproductive system


  • May involve any organ, or combinations of organs, of the upper genital tract:

    • uterus, fallopian tubes or ovaries

    • in severe form the entire peritoneal cavity.

  • Usually PID is caused by sexually transmitted microorganisms that migrate from the vagina to the uterus, fallopian tubes and the ovaries.

Pid under ultrasound

PID Under Ultrasound



Pid under ultrasound1

PID Under Ultrasound

Chronic PID

Pid under hysterosalpingogram


PID Under Hysterosalpingogram

Pid under hysterosalpingogram1

Not So


PID Under Hysterosalpingogram

Benign growth and proliferative condition

Benign Growth and Proliferative Condition

Benign Ovarian Cysts

Benign ovarian cysts

Benign Ovarian Cysts

  • Simple ovarian cysts are usually follicular or corpus luteum in origin.

  • Follicular cysts

    • Develops from a fominant ovarian follicle that does not release its own ovum but remains active

    • Not usually systematic

    • Usually require no treatment

    • They either regress or rupture spontaneously.

Benign ovarian cysts1

Benign Ovarian Cysts

  • Symptoms include (if any):

    • Painful intercourse, chronic lower abdominal pain and menstrual irregularities.

  • Corpus Luteum Cysts

    • Develops from a mature corpus luteum - persists abnormally and continues to secrete progesterone.

    • The cyst contains blood or fluid that accumulates in the corpus luteum cavity.

Benign ovarian cysts2

Benign Ovarian Cysts

  • Symptoms if any include:

    • Dull pelvic pain, delayed menstruation followed by irregular or heavier than normal bleeding.

    • Rupture can cause excruciating pain levels and requires immediate surgery

    • Oral contraceptives may be used to prevent cysts in the future

Dermoid cysts

Dermoid Cysts

  • The teratoma is the most common germ cell tumour and it contains a varying mixture of skin, hair, fatty elements and calcified teeth.

Dermoid cyst

Dermoid Cyst

Dermoid cyst1

Dermoid Cyst

Leiomyomas uterine fibroids

Leiomyomas (Uterine Fibroids)

  • Benign tumours that develop from smooth muscle cells in the myometrium.

  • Most common benign tumours of the uterus.

  • Size of the tumour relates to hormonal fluctuations.

Leiomyomas uterine fibroids1

Leiomyomas (Uterine Fibroids)

Leiomyomas uterine fibroids2

Leiomyomas (Uterine Fibroids)

  • Characteristic mottled, mulberry, or popcorn type of appearance.

  • Able to be seen on plain abdominal x-ray as smooth or lobulated nodules with a stippled appearance.

  • A large Fibroid adenoma may occupy the entire pelvis.

Leiomyomas uterine fibroids3

Leiomyomas (Uterine Fibroids)

  • I.V.P.

    • Persistent uterine opacification is seen in patients with underlying fibroid tumour.

    • The tumour typically presses on the fundus of the bladder, causing a lobulated impression usually seen with ovarian cysts.

    • Extension of a fibroid into the adjacent tissues may cause medial displacement of the pelvic ureter or ureteral compression leading to hydronephrosis.

Leiomyomas uterine fibroids4

Leiomyomas (Uterine Fibroids)

  • Ultrasound shows a hypoechoic, solid contour-deforming mass in an enlarged inhomogenous uterus.



  • Most lesions are small and difficult to distinguish from normal tissue even when using modalities like CT and MRI.

  • This is the presence of normal appearing endometrium in sites other than their normal location inside the uterus.

    • Usually the ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum are most frequent, but the GI and Urinary tracts may also become affected.



  • Symptoms

    • Abdominal cramps, diarrhoea during menstruation and may appear either as single or multiple masses in the colon.

    • Endometriosis involving the urinary tract most commonly produces ureteral obstruction below the level of the pelvis brim.

Cervical cancer

Cervical Cancer

  • May be detected in the early, curable stage by Pap test.

  • Increased manifestations may occur due to:

    • early age coitus, many sexual partners, genital herpes virus infections, poor obstetric and gynaecological care.

    • May be watery vaginal discharge or occasional spotting of blood.

Cervical cancer1

Cervical Cancer

  • Advanced lesions may have the following symptoms:

    • foul smelling vaginal discharge, leaking from bladder or rectal fistulas, anorexia, weight loss, back and leg pains.

Cervical cancer2

Cervical Cancer

  • Ultrasound usually demonstrates a cervical carcinoma as a solid echogenic mass behind the bladder.

Cervical cancer3

Cervical Cancer

Cervical cancer4

Cervical Cancer

  • CT is more accurate in detecting pelvic sidewall invasion and therefore is usually the initial staging procedure in patients in whom there is a clinical suspicion of advanced disease.

  • May show bladder invasion of carcinoma.

Cervical cancer5

Cervical Cancer

Cervical cancer6

Cervical Cancer

Cervical cancer7

Cervical Cancer

  • MRI can allow the cervix to be distinguished from the uterus and vagina.

Cervical cancer8

Cervical Cancer

Endometrial cancer

Endometrial Cancer

  • A malignant disease of the endometrium of the uterus

  • Most commonly occurs in the 5th or 6th decade of life.

  • Abnormal vaginal bleeding is the most common sign especially in a post menopausal woman

  • Endometrial lesions may invade the cervix but rarely the vagina.

Endometrial cancer1

Endometrial Cancer

  • Typical Ultrasound appearance is an enlarged uterus with irregular areas of low-level echoes and bizarre clusters of high-intensity echoes.

Endometrial cancer2

Endometrial Cancer

Endometrial cancer3

Endometrial Cancer

  • CT demonstrates focal or diffuse enlargement of the body of the uterus.

Endometrial cancer4

Endometrial Cancer

Endometrial cancer5

Endometrial Cancer

  • MRI allows differentiation of the endometrium (inner layer) from the myometrium (muscle layer) of the uterus and has been useful in demonstrating focal or diffuse endometrial tumours.

Endometrial cancer6

Endometrial Cancer

Ovarian cancer

Ovarian Cancer

  • Asymptomatic in early stages and therefore it is often not detected until it has metastasised.

  • Cystadenocarcinoma of the ovary often shows on ultrasound examination as a large cystic mass with internal septa.

  • Difficult to distinguish from Cystadenoma.

  • They often calcify.

Ovarian cancer1

Ovarian Cancer

Ovarian cancer2

Ovarian Cancer

Ovarian cancer3

Ovarian Cancer

Disorders of the male reproductive system

Disorders of the Male Reproductive System





Disorders of the penis

Disorders of the Penis

  • Phimosis

    • condition where the foreskin cannot be pulled back because it is too tight





  • This is where the foreskin cannot be moved forward to cover the glans



Peyronie disease

Peyronie Disease

  • Bent nail syndrome

    • fibrotic condition that causes lateral curvature of the penis during erection.

    • It develops slowly and is characterised by fibrous thickening of the fascia in the erectile tissue of the penis.

    • May cause pain on erection and intercourse.

Peyronie disease1

Peyronie Disease



  • Prolonged penile erection

    • usually painful and not associated with arousal.





  • Inflammation of the Glans penis.

  • Associated with poor hygiene and phimosis.

  • Circumcision may prevent further recurrence.



Penile cancer

Penile Cancer

  • Very rare 1% of all malignancies.

  • Usually occurs in unhygienic people who are not circumcised.

  • Unknown origin.

  • Thought to develop as a result of chronic irritation caused by smegma beneath a phimotic foreskin.

  • Velvety, ulcerative lesions to large scaly growths.

  • Usually affects the penile shaft.

Penile cancer1

Penile Cancer

  • 30% of penis cancers spread to lymph nodes before diagnosis.

  • Distant metastases occur in less than 10% of cases.

Cancer of the testis

Cancer of the Testis

  • One of the most curable cancers. (95%)

  • The most common tumour of young men (15 to 34 years of age).

  • Cause is unknown

    • trauma and infection-related testicular atrophy have been associated with testicular tumours.

Cancer of the testis1

Cancer of the Testis



  • Inflammation of the epididymitis

    • Usually occurs in sexually active males.

    • The usual case is a sexually transmitted disease which causes Epididymitis.



Carcinoma of the prostate

Carcinoma of the prostate

  • More than 95% of prostatic neoplasms are adenocarcinomas, and most occur in the periphery of the prostate.

  • 42% of all cancer in men.

  • Cause is not well understood.

    • Genetic predisposition

    • Diet related

Carcinoma of the prostate1

Carcinoma of the prostate

Carcinoma of the prostate2

Carcinoma of the prostate

Carcinoma of the prostate3

Carcinoma of the prostate

Carcinoma of the prostate4

Carcinoma of the prostate

Metastatic carcinoma of prostate

Metastatic Carcinoma of Prostate

Metastatic carcinoma of the prostate

Metastatic Carcinoma of the prostate

Disorders of the breast

Disorders of the Breast

Breast Cancer

Benign Breast Disease

Breast cancer

Breast Cancer

  • Most Common malignancy among women.

  • Mammograms providing compression and magnification techniques greatly improve the diagnostic value of an image.

  • Typically the malignant tumour mass is poorly defined, has irregular margins, and demonstrates numerous fine linear strands radiating out from the mass.

Breast cancer1

Breast Cancer

As opposed to benign breast masses

As Opposed to Benign Breast Masses

Breast cancer2

Breast Cancer

  • May appear as numerous tiny calcifications with linear, curvilinear, and branching forms of malignancy.

Breast cancer3

Breast Cancer

Breast cancer4

Breast Cancer

  • Ultrasound can differentiate a benign cyst from a solid mass.

  • Ultrasound however is not good in detecting nonpalpable cancers, particularly with those presenting with calcifications alone.

Breast cancer5

Breast Cancer

Sexually transmitted infections

Sexually Transmitted Infections

Bacterial Infections



Hepatitis B




  • Bacterial infection which is the most common bacterial infection that is one of the most widespread of the venereal diseases.

  • Symptoms usually include acute urethritis with copious discharge of pus in men.

  • In women they may get urethral or cervical inflammation and usually symptoms are minimal.





  • Gonorrhoeal infection can cause septic arthritis leading to articular erosion and joint space narrowing.

  • Infection may lead to stenosis or stricture of the urethra.





  • Chronic sexually transmitted systemic infection caused by the spirochaete bacterium.

  • May be passed on to newborn baby.

  • In the primary stage of the disease

    • a chancre or ulceration develops on the genitals.





  • If untreated with antibiotics, the second phase appears as a non-itching rash on any part of the body. (6 weeks)





  • Condylomata lata lesions may appear also which are watery, flat, moist, wartlike lesions.

    • These lesions are highly contagious.







  • Cardiovascular Syphilis primarily involves the ascending aorta (tertiary phase).

  • Syphilis is major cause of neuropathic joint disease in which bone resorption and total disorganisation of the joint with associated with calcification and bony debris.







Genital herpes viral infection

Genital herpes (Viral Infection)

  • Causes blisters (cold sores) is the most common infectious genital infection.

  • Transmitted through intimate contact.

  • May be transmitted through a secreting lesion or mucosal surface.

Genital herpes

Genital herpes

Condylomata acuminata

Condylomata Acuminata

  • Genital Warts.

  • Caused by the human papilloma virus (HPV).

  • HPV infection is closely associated with multiple sexual partners and early onset of sexual activity.

  • These warts are quite contagious.

Condylomata acuminata1

Condylomata Acuminata

Topics covered previously

Topics covered previously:

  • HIV Virus

  • Hepatitis B Infections

The end of the reproductive system


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