Chapter 42 Pathology of the Ovaries Flashcards
In the anteflexed midline uterus, the ovaries are usually identified ______ or ________.
laterally, posterolaterally
Following hysterectomy, the ovaries tend to located more _______ and directly superior to the vagina cuff.
medially
The normal ovary has a(n) ________ echotexture, which may exhibit a central, more echogenic medulla with small anechoic or cystic follicles seen in the cortex.
homogeneous
Small anechoic or cystic follicles may be seen __________ in the cortex.
periplerally
During the early _______ phase, many follicles develop and increase in size until about day 8 or 9 of the menstrual cycle.
proliferative
The ________ may occasionally be detected as an eccentrically located, cystlike, 1-mm internal mural protrusion.
cumulus oophorus
If the fluid in the nondominant follicles is not reabsorbed, a(n) _______ cyst develops.
follicular
The occurrence of fluid in the cul-de-sac is commonly seen after ovulation and peaks in the early ______ phase.
luteal
Following ovulation in the luteal phase, a mature _________ develops and may be identified sonographically as a small hyopechoic or isoechoic structure peripherally within the ovary.
corpus luteum
Any simple ________ that hemorrhages may appear as a complex mass.
cyst
The more sonographically complex the tumor, the more likely it is to be _______, especially if associated with ascites.
malignant
Patients with normal menstrual cycles are best scanned in the first ______ days of the cycle; this prevents confusion with normal changes in intraovarian blood flow because high diastolic flow occurs in the luteal phase.
10
A mass showing complete absence of or very little diastolic flow (very elevated RI and PI values) is usually ________.
benign
Duplex Doppler reveals prominent _______ flow in corpus luteum cysts. This low-velocity waveform is present throughout the luteal phase of the cycle.
diastolic
Echogenic, free intraperitoneal fluid in the cul-de-sac can help confirm the diagnosis of a ________ or leaking hemorrhagic cyst.
ruptured
The largest of the functional cysts are _________ and appear as very large, bilateral, multiloculated cystic masses. This mass is associated with high levels of human chorionic gonadotropin (hCG) and is seen most frequently in association with gestational trophoblastic disease.
theca-lutein cysts
A frequent iatrogenic complication of ovulation induction is __________. The ovaries are enlarged but measure less than 5cm in diameter.
Ovarian Hyperstimulation Syndrome
An endocrinologic disorder associated with chronic anovulation with an imbalance of LH and FSH resulting in abnormal estrogen and androgen production is _________.
polycystic ovarian syndrome
Paraovarian cysts account for approximately 10% of adnexal masses; they arise from the _________ ligament and usually are of mesothelial paramesonephric origin.
broad
Endometriosis is a common condition in which functioning __________ tissue is present outside the uterus
endometrial
The localized form consists of a discrete mass called an endometrioma, or _________.
Chocolate Cyst
Endometriosis may appear as bilateral or unilateral ovarian cysts with patterns ranging from anechoiic to solid, depending on the amount of _______ and its organization.
blood
Torsion of the ovary is caused by a partial or _________ rotation of the ovarian pedicle on its axis
complete
Ovarian torsion produces an enlarged ________ ovary, usually greater than 4cm in diameter.
edematous
Unilocular or thinly septated cysts are more likely to be ______.
benign
Multilocular thickly septated masses and masses with solid nodules are more likely to ________.
malignant
Ovarian cancer can present as a complex, cystic, or solid mass, but it is more likely preponderantly ________.
cystic
The incidence of ovarian cancer is greatly ________ in women who have had breast or colon cancer.
increased
Malignant tumor growth is dependent on ___________ with the development of abnormal tumor vessels. This leads to decreased vascular resistance and higher diastolic flow velocity.
angiogenesis
Sonography may demonstrate one of several patterns: (1) a completely cystic mass; (2) a cystic mass with a very echogenic nodule along the mural wall representing a _________; (3) a ____________ level; (4) high-amplitude echos with __________ (e.g., teeth or bone); or (5) a complex mass with ________ septations.
demoid plug, fat-fluid level, shadowing, internal
The _______ are more involved with metastatic disease than any other pelvic organ.
ovaries
