A 41-year-old G5, P5 woman has noticed lower abdominal pain with fever for the past 2 days. She delivered a normal term infant 1 week ago. On examination, she has a temperature of 37.4degC. There is a foul-smelling vaginal discharge. Which of the following pathologic findings is she most likely to have?
Acute endometritis in this case is the result of retained products of conception after delivery. Endometritis may also follow the premature rupture of membranes with ascending infection to the uterine cavity. There is often polymicrobial infection with organisms found in the vagina. Some cases of chronic endometritis may be associated with Neisseria and Chlamydia infections and produce lymphoplasmacytic infiltrates within the endometrium. Cervical dysplasia is confined to the epithelium and is usually asymptomatic so that detection is by Pap smear. A myometrial neoplasm is unlikely to produce acute inflammation. An ovarian endometrioma is a mass lesion resulting from continued hemorrhage into a focus of endometriosis, but this mass lesion is not associated with pregnancy, and endometriosis may be a cause for infertility. Mycobacterium tuberculosis infection may spread to the female genital tract, most often the fallopian tube, but acute signs are unlikely to be present, and inflammation of the tube can be a cause for infertility. Vaginitis may produce acute inflammation with discharge, but trichomonal infections typically are associated with a watery gray-to-green discharge.
Cervical intraepithelial neoplasia
Endometrial neutrophilic infiltrates
Myometrial smooth muscle neoplasm
Ovarian endometrioma
Female Genital Tract