21 - Female genital tract Flashcards by Jasper Viloria

Lesion of the female vulva characterized by thinning of the epidermis and disappearance of rete pegs, hydropic degeneration of basal cells, superficial hyperkeratosis, dermal fibrosis with scant perivascular, mononuclear inflammatory cell infiltrate. Occurs most commonly in postmenopausal women.

Lichen sclerosus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

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This disorder of the vulva is marked by epithelial thickening, expansion of the stratum granulosum, significant surface hyperkeratosis and pronounced leukocytic infiltrate. Appears clinically as an area of leukoplakia.

Lichen simplex chronicus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

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These are flat, moist, minimally elevated lesions that occur in secondary syphilis.

Condyloma lata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

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Lesions of the anogenital area which may be papillary and distinctly elevated or may be somewhat flat and rugose. Characteristic cellular morphology is the presence of cytoplasmic vacuolization with nuclear angular polymorphism and koilocytosis. Hallmark of HPV infection.

Condyloma acuminata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

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Red, scaly plaque, microscopically characterized by the spread of malignant cells within the epithelium, occasionally with invasion of underlying dermis. May have underlying carcinoma of a vulvar or perineal gland.

Paget disease of the Vulva(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 715

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A soft polypoid mass, which is a rare form of primary vaginal cancer. Usually encountered in infants and children less than 5 y/o.

Sarcoma botryoides (embryonal rhabdomyosarcoma)(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 716

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Most commonly develops in the transformation zone of the cervix. Produces a “barrel cervix” if the tumor encircles the cervix and invades the underlying stroma.

Invasive carcinoma of the cervix(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 719

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Protruding polypoid masses which are inflammatory in origin, soft, yields to palpation, and have a smooth, glistening surface with underlying cystically dilated spaces filled with mucinous secretion.

Endocervical polyp(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

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Refers to the growth of the basal layer of the endometrium down to the myometrium. Nests of endometrial stroma, glands or both are found in the myometrium, in between muscle bundles.

Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

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Characterized by the presence of endometrial glands and stroma in a location outside the endomyometrium. Undergoes cyclic bleeding. Also called “chocolate cysts”.

Endometriosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722

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These are sharply circumscribed, firm, gray-white masses of the uterus, with “whorled” cut surface.

Leiomyoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

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Solitary tumors of the uterus which arise de novo from the mesenchymal cells of the myometrium. Characterized by the presence of tumor necrosis, cytologic atypia and mitotic activity.

Leiomyosarcomas

(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725

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Type of endometrial carcinoma associated with estrogen excess and endometrial hyperplasia.

Endometroid carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

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Type of endometrial carcinoma which occurs in older women and is usually associated with endometrial atrophy.

Serous carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

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(2) Small, fluid-filled cysts which originate from the unruptured graafian follicles or in follicles that have ruptured and immediately sealed.

Follicle and luteal cysts(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

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Triad of oligomenorrhea, infertility and obesity in young women secondary to excessive production of estrogens and androgens.

Polycystic ovaries(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

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Other name for polycystic ovary syndrome?

Stein-Leventhal syndrome(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

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Two most important risk factors for development of ovarian cancer.

Nulliparity and family history(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

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Mutation of this gene is associated in the development of both ovarian and breast cancers.

BRCA 1(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

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Mutation of this gene is associated with the development of breast cancer only,

BRCA 2(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

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Benign lesion of the ovary most commonly seen in women 30-40 years old. Most frequent of the ovarian tumors. Serosal covering is smooth and glistening. Characterized histologically by tall, columnar epithelium and the presence of Psammoma bodies.

Serous tumor of the ovary(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 730

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Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

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Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

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A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract.

Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

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Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses

Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.

Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735

This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.

Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

This type of H. mole shows villous edema that involves only some of the villi and the trophoblastic proliferation is focal and slight, with characteristic irregular scalloped margin. Fetal parts/embryo may be seen.

Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

These are complete moles that are more invasive locally but do not metastasize. Microscopically, the epithelium of the villi is marked by hyperplastic and atypical changes, with proliferation of both cuboidal and syncytial components.

Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.

Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

On transection, filled with sebaceous secretion and matted hair, bone and cartilage, nests of bronchial or gastrointestinal epithelium, and other recognizable lines of development are also present.

Benign (Mature) Cystic Teratomas / Dermoid Cyst(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

In gonococcal infection of the female reproductive system, inflammatory changes will appear about how many days after the inoculation of the organism?

2-7 days (TOPNOTCH)

These cells are distinguised by a clear separation "halo" from the surrounding epithelial cells and a finely granular cytoplasm containing mucopolysaccharide that stains with PAS, Alcian Blue, and Mucicarmine

Paget cells (TOPNOTCH)

What is the probable precursor of vaginal adenocarcinoma?

Vaginal adenosis (TOPNOTCH)

What do you call the glandlike structures filled with an acidophilic material similar to immature follicles that are seen in Granulosa Theca Cell tumors?

Call Exner bodies (TOPNOTCH)

Presence of these structures characterize serous tumors of the ovaries

Psammoma bodies (TOPNOTCH)

These tumors are distinguished from serous and mucinous tumors of the ovaries by the presence of tubular glands that resemble the endometrium

Endometriod tumor (TOPNOTCH)

A key factor in the development of endometrial hyperplasia and related cancers is the inactivation of what tumor suppressor gene?

PTEN (TOPNOTCH)

What is the most common location of vaginal adenocarcinoma?

Anterior wall of the upper third of Vagina (TOPNOTCH)

This is a condition in which glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it

Vaginal Adenosis (TOPNOTCH)

What are the 4 cardinal histologic features of Lichen Sclerosus of the Vulva or Chronic atrophic vulvitis?

Atrophy of the epidermis with disappearance, of the rete pegs, hydrophic degeneration of the basal cells, replacement of the underlying dermis by dense collagenous fibrous tissue, and monoclonal band like lymphocytic infiltrate (TOPNOTCH)

Morphology: acanthosis of the vulvar squamous epithelium frequently with hyperkeratosis

Lichen Simplex Chronicus (TOPNOTCH)

Morphology: presence of large tumor cells lying singly or in small lusters within the epidermis and its appendages

Extra mammary Paget Disease (TOPNOTCH)

Morphology: tumor cells resemble tennis racket with small protrusions of cytoplasms from one end

Embryonal Rhabdomyosarcoma (TOPNOTCH)

Clustering of tumor cells in a so called "Cambium Layer" is seen in what type of rhabdomyosarcoma?

Embryonal Rhabdomyosarcoma (TOPNOTCH)

On histological examination of the cervix, epithelial spongiosis is associated with what type of infection?

Trichomonas vaginalis infection (TOPNOTCH)

On histological examination of the cervix, epithelial ulcers with intranuclear inclusions within the epithelial cells and lymphocytic infiltration is associated with what type of infection?

HSV (TOPNOTCH)

Morphology: these are composed of dense fibrous stroma covered with endocervical columnar epithelium

Endocervical polyp (TOPNOTCH)

This pathogen is considered the most important agent in cervical oncogenesis:

HPV (TOPNOTCH)

Koilocytic atypia is considered what type of CIN lesion?

CIN I (TOPNOTCH)

What is the most common pattern seen in invasive cervical carcinoma?

Fungating (TOPNOTCH)

On histological examination of the endometrium, what is the earliest morphological evidence of ovulation?

Basal vacuolation (TOPNOTCH)

Morphology: ectopic endometrial glands and stroma with numerous macrophages containing hemosiderin

Endometriosis (TOPNOTCH)

The combination of ovarian tumor, hydrothorax, and ascites is designated as

Meigs Syndrome (TOPNOTCH)

What type of ovarian cancer is best considered as the counterpart of the seminoma of the testes?

Dysgerminoma (TOPNOTCH)

About 1% of the dermoids undergo malignant transformation of any one of the component elements present, but most commonly, they differentiate into what type of carcinoma?

Squamous Cell Carcinoma (TOPNOTCH)

Morphology: characterized by a lining of tall columnar epithelial cells with apical mucin and the absence of cilia, resembling cervical or intestinal epithelium

Mucinous tumors (TOPNOTCH)

Morphology: lined by a rim of bright yellow luteal tissue containing luteinized granulosa cells

Luteal cyst (TOPNOTCH)

Earliest lesions consist of red papules progressing to vesicles then to painful coalescent ulcers on the vulvar or vaginal area. Smears shows multinucleated squamous cells with basophilic viral inclusion with a ground-glass appearance. This is caused by:

HSV (TOPNOTCH) Robbins Basic Pathologym 9th ed, p. 993

Presents with pearly, dome-shaped papules with a dimpled center. Central waxy core contains cells with cytoplasmic viral inclusion. The lesion described is:

Molluscum contagiosum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 993

Manifests with vulvovaginal pruritus, erythema, swelling, and curdlike vaginal discharge. Wet KOH mount of discharge shows pseudospore or filamentous fungal hyphae.

Candidiasis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

Presents with yellow, frothy vaginal discharge, vulvovaginal discomfort, dysuria, and dyspareunia. The vaginal and cervical mucosa typically has a fiery red appearance, with marked dilatation of cervical mucosal vessels ("strawberry cervix"). The cause is:

Trichomonas vaginalis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

Presents with thin, green-gray, fishy vaginal discharge. Pap smear reveal squamous cells covered with a shaggy coating coccobacilli.

Bacteria vaginosis(caused by Gardnerella vaginalis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

This infection is characterized by marked acute inflammation of mucosa; smears of inflammatory exudate shows phagocytosed gram-negative diplococci within neutrophils.

Gonococcal infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 995

Most common site of vaginal carcinoma

Upper vagina, posterior wall at the junction with ectocervix(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1000

True or False: All HSILS are considered to be at high risk for progression to carcinoma.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1003

Viral proteins implicated in the ability of HPV to act as carcinogen by interfering with the activity of tumor suppressor proteins.

E6 and E7(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1002

Most common histologic subtype of cervical carcinoma

Squamous Cell Carcinoma (TOPNOTCH)

Most common high-risk HPV type causing cervical precursor lesions and cervical carcinomas.

HPV-16.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1007

Most frequent cause of dysfunctional bleeding

Anovulation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1009

Disease of women in active reproductive life; causes infertility, dysmenorrhea, pelvic pain. Endometrial glands and stroma outside of the uterus.

Endometriosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1012

An important cause of abnormal uterine bleeding; frequent precursor to endometrial carcinoma; most commonly caused by by unopposed estrogen stimulation.

Endometrial hyperplasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013

Most common invasive cancer of the female genital tract

Endometrial carcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013

True or False. Malignant transformation of leiomyoma to leiomyosarcoma is rare.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1020

The majority of ovarian neoplasm arise from?

Mullerian epithelium(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023

The most common primary malignant ovarian tumor

Serous adenocarcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023

Most common germ cell tumor of the ovary in women of reproductive age

Mature cystic teratoma/dermoid cyst(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

Glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space lined by tumor cells

Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

Characteristic histologic feature of Yolk Sac Tumor

Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

Ovarian tumor that may elaborate large amounts of estrogen; Two thirds occur in post-menopausal women; potentially malignant

Granulosa cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032

Biomarker useful for identifying granulosa an other sex cord-stromal tumors, and monitoring treatment.

Serum inhibin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032

Serum marker for ovarian carcinoma

CA-125(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1029

Ovarian tumor that often functional and commonly produce masculinization or defeminization; peak incidence 20-30 y/o; cut surface is usually solid, gray to golden brown in appearance.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. `033

Most common extra-mullerian tumors metastatic to the ovary

Carcinoma of the breast and GIT(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1034

Systemic syndrome characterized by widespread maternal endothelial dysfunction that presents during pregnancy with hypertension, edema, and proteinuria.

Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1034

Morphology: placental infarcts, retroplacental hematoma, abnormal decidual vessels, fibrin thrombi in the portal capillaries and hemorrhagic necrosis of the liver, kidney glomeruli show marked swelling of endothelial cells, mesangial cell hyperplasia, amorphous dense deposits on the endothelial side of basement membrane.

Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1039

Choriocarcinoma is most often preceded by:

Complete H. mole(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1041

A 44 year old G3P3 has a routine Pap smear, which reported "LSIL." A colposcopy showed a reddish area in the posterior cervix. Biopsy showed an intact squamous epithelium with some cells showing dark, angulated nuclei surrounded by a clear cytoplasm. The biopsy will be read as (A) normal (B) CIN I (C) CIN II (D) CIN III

CIN I (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 718-719

A 38 year old G2P2 presents with dysmenorrhea and menorrhagia. Ultrasound shows a symmetrically enlarged uterus, with a 4 cm thick myometrium, and endometrium with normal thickness. She opts to have a hysterectomy. The histopathology showed nests of endometrial glands and stroma in the myometrium between the muscle bundles. The endometrium is described as "proliferative." She has: (A) leiomyoma (B) adenomyosis (C) endometrial stromal sarcoma (D) endometrial carcinoma

(B) adenomyosis

A 42 year old G4P4 has had a 20 year history of dysmenorrhea. An ultrasound shows a right adnexal cyst. She undergoes a right salpingoophorectomy. The right ovary has been converted to a 10 cm diameter brown cystic mass, filled with dark brown fluid. The internal surface is shaggy. Microscopic examination shows hemorrhage and hemosiderin deposits, and occasional endometrial glands and stroma. This lesion (A) contains nonfunctioning endometrium (B) probably originated from retrograde implantation of menstrual endometrium (C) is malignant (D) all of the above

probably originated from retrograde implantation of menstrual endometrium (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722

Which of the following is associated with endometrial hyperplasia? (A) Stein-Leventhal syndrome (B) granulosa-theca cell tumors (C) obesity (D) all of the above

all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723

Which of the following has the highest risk of developing endometrial carcinoma? (A) cystically dilated endometrial glands, with single layer of endometrial cells (B) crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (C) nests of closely packed glands with single layer of endometrial cells (D) regularly spaced endometrial glands, with epithelium exhibiting supranuclear vacuoles, and stromal edema

B - crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (complex hyperplasia with atypia) A- disordered endometrium; C - hyperplasia without atypia; D - secretory endometrium

A 48 year old G0P0 woman has menorrhagia. Ultrasound shows multiple sharply circumscribed myometrial and submucosal masses. She undergoes hysterectomy. Histopathology showed whorled bundles of smooth muscle cells, with rare mitoses, and no necrosis. These masses (A) commonly transform into sarcomas (B) may shrink postmenopausally (C) are polyclonal (D) all of the above are true

B - may shrink postmenopausally

Which of the following is a risk factor for endometrial carcinoma (A) obesity (B) diabetes mellitus (C) hypertension (D) all of the above

(D) all of the above

In endometrial carcinomas, which histologic pattern is associated with p53 mutations, arises in a background of endometrial atrophy, and has a poor prognosis? (A) serous (B) mucinous (C) endometrioid (D) adenosquamous

serous (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 726

A 22 year old presents with signs of acute abdomen. On history, she has been amenorrheic for 8 weeks. Pelvic examination showed a tender right adnexal mass. She undergoes emergency laparotomy with right salpingectomy. At histopathology, the fallopian tube is dilated with a point of rupture. The lumen is filled with blood clots. Which of the following histopathologic findings proves tubal pregnancy? (A) decidualized tubal epithelium (B) infiltrates of neutrophilic agreggates and necrosis (C) diffuse hemorrhage and fibrin deposition (D) chorionic villi

(D) chorionic villi

Which of the following statements on ovarian cancer is true? (A) the risk is higher in BRCA 2 mutations than in BRCA1 (B) multiparity is a risk factor (C) oral contraceptives somewhat reduces the risk (D) all of the above

Epithelial tumors of the ovary can be benign, borderline, or malignant. Which histologic type is more likely to be malignant than benign? (A) serous (B) mucinous (C) endometrioid

endometrioid (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

A 17 year old female presents with a 10 cm left ovarian cyst and undergoes oophorectomy. On histopathology, the cyst is filled with sebum and hair. There is a solid area with a gritty cut surface. Which of the following histologic findings characterizes the tumor as immature? (A) islands of cartilage and bone (B) nests of pseudostratified epithelium (C) sheets of round cells with scant cytoplasm, some forming rosettes (D) foci of glial cells admixed with neuropil

C - sheets of round cells with scant cytoplasm, some forming rosettes (neuroepithelial differentiation)

Which of the following ovarian tumors can produce virilizing signs and symptoms? (A) granulosa cell tumor (B) thecoma (C) sertoli-leydig tumor (D) dysgerminoma

Sertoli-Leydig cell tumor

Which of the following trophoblastic lesions has a triploid karyotype? (A) complete mole (B) partial mole (C) invasive mole (D) placental site trophoblastic tumor

Partial mole

Which of the following tumors is most responsive to chemotherapy? (A) gonadal choriocarcinoma (B) gestational choriocarcinoma (C) placental site trophoblastic tumor

gestational choriocarcinoma