Chapter 42 Pathology of the Ovaries

Question 1

In the anteflexed midline uterus, the ovaries are usually identified ______ or ________.

Answer 1

laterally, posterolaterally

Question 2

Following hysterectomy, the ovaries tend to located more _______ and directly superior to the vagina cuff.

Answer 2

medially

Question 3

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.

Answer 3

homogeneous

Question 4

Small anechoic or cystic follicles may be seen __________ in the cortex.

Answer 4

periplerally

Question 5

During the early _______ phase, many follicles develop and increase in size until about day 8 or 9 of the menstrual cycle.

Answer 5

proliferative

Question 6

The ________ may occasionally be detected as an eccentrically located, cystlike, 1-mm internal mural protrusion.

Answer 6

cumulus oophorus

Question 7

If the fluid in the nondominant follicles is not reabsorbed, a(n) _______ cyst develops.

Answer 7

follicular

Question 8

The occurrence of fluid in the cul-de-sac is commonly seen after ovulation and peaks in the early ______ phase.

Answer 8

luteal

Question 9

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.

Answer 9

corpus luteum

Question 10

Any simple ________ that hemorrhages may appear as a complex mass.

Answer 10

cyst

Question 11

The more sonographically complex the tumor, the more likely it is to be _______, especially if associated with ascites.

Answer 11

malignant

Question 12

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.

Answer 12

10

Question 13

A mass showing complete absence of or very little diastolic flow (very elevated RI and PI values) is usually ________.

Answer 13

benign

Question 14

Duplex Doppler reveals prominent _______ flow in corpus luteum cysts. This low-velocity waveform is present throughout the luteal phase of the cycle.

Answer 14

diastolic

Question 15

Echogenic, free intraperitoneal fluid in the cul-de-sac can help confirm the diagnosis of a ________ or leaking hemorrhagic cyst.

Answer 15

ruptured

Question 16

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.

Answer 16

theca-lutein cysts

Question 17

A frequent iatrogenic complication of ovulation induction is __________. The ovaries are enlarged but measure less than 5cm in diameter.

Answer 17

Ovarian Hyperstimulation Syndrome

Question 18

An endocrinologic disorder associated with chronic anovulation with an imbalance of LH and FSH resulting in abnormal estrogen and androgen production is _________.

Answer 18

polycystic ovarian syndrome

Question 19

Paraovarian cysts account for approximately 10% of adnexal masses; they arise from the _________ ligament and usually are of mesothelial paramesonephric origin.

Answer 19

broad

Question 20

Endometriosis is a common condition in which functioning __________ tissue is present outside the uterus

Answer 20

endometrial

Question 21

The localized form consists of a discrete mass called an endometrioma, or _________.

Answer 21

Chocolate Cyst

Question 22

Endometriosis may appear as bilateral or unilateral ovarian cysts with patterns ranging from anechoiic to solid, depending on the amount of _______ and its organization.

Answer 22

blood

Question 23

Torsion of the ovary is caused by a partial or _________ rotation of the ovarian pedicle on its axis

Answer 23

complete

Question 24

Ovarian torsion produces an enlarged ________ ovary, usually greater than 4cm in diameter.

Answer 24

edematous

Question 25

Unilocular or thinly septated cysts are more likely to be ______.

Answer 25

benign

Question 26

Multilocular thickly septated masses and masses with solid nodules are more likely to ________.

Answer 26

malignant

Question 27

Ovarian cancer can present as a complex, cystic, or solid mass, but it is more likely preponderantly ________.

Answer 27

cystic

Question 28

The incidence of ovarian cancer is greatly ________ in women who have had breast or colon cancer.

Answer 28

increased

Question 29

Malignant tumor growth is dependent on ___________ with the development of abnormal tumor vessels. This leads to decreased vascular resistance and higher diastolic flow velocity.

Answer 29

angiogenesis

Question 30

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.

Answer 30

demoid plug, fat-fluid level, shadowing, internal

Question 31

The _______ are more involved with metastatic disease than any other pelvic organ.

Answer 31

ovaries