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Gyn Imaging 118/119 > Chapter 44- Ovarian Pathology > Flashcards

Chapter 44- Ovarian Pathology Flashcards

1
Q

Where is a cumulus oophorous found?

A

within the dominant follicle

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2
Q

what is a corpus luteum

A

a ruptured dominant follicle seen in the post-ovulation luteal phase

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3
Q

how does a corpus luteum appear sonographically?

A

anechoic with thick walls and a “ring of fire” effect with color doppler

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4
Q

what are echogenic foci and what causes them

A

small echogenic but non-shadowed cystic areas in an ovary caused by previous infection or hemorrhage

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5
Q

When might volume of an ovary be considered abnormal?

A

If it is more than double the volume of the opposite ovary

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6
Q

what is the normal post-menopausal ovary volume

A

less than 8 mL

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7
Q

when might surgical intervention be considered for a follicular cyst

A

if the cyst is greater than 6cm for more than 8 weeks

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8
Q

how does a follicular cyst appear sonographically

A

more than 3 cm and anechoic with thin walls and posterior enhancement

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9
Q

what might cause the development of a follicular cyst

A

if the fluid from non-dominant follicles is not reabsorbed.

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10
Q

what is the function of the ovary

A

produce the oocytes and hormones needed for ovulation

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11
Q

what are the majority of ovarian masses?

A

benign simple cysts

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12
Q

if a cyst is more complex, what can we assume about it?

A

if it is more complex it is more likely to be malignant, especially with ascites

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13
Q

are serous or mucinous tumors more common?

A

serous

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14
Q

if a mass has absent or minimal blood flow, what can we assume about it?

A

it is more likely to be benign.

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15
Q

what are some examples of a functional cyst

A

follicular, corpus luteum, theca lutein

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16
Q

What is the largest type of functional cyst?

A

Theca-Lutein

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17
Q

What is the most common benign ovarian tumor?

A

Dermoid/Teratoma

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18
Q

What is the second most common benign ovarian tumor?

A

Serous Cystadenoma

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19
Q

What is the most common pelvic organ to develop metastatic disease

A

Ovaries

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20
Q

What stage of ovarian cancer does metastasis usually mimic?

A

Stage II or III

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21
Q

What is a Krukenberg tumor?

A

A metastatic tumor that drops to the ovary from GI tract or other organs or spreads through the lymphatic system

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22
Q

What is the most common ovarian cancer? What percent of all ovarian cancer?

A

Serous Cystadenocarcinoma is 60-80% of all ovarian cancers.

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23
Q

Which ovarian tumors are typically larger, serous or mucinous?

A

Mucinous are larger

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24
Q

What are germ cell tumors?

A

tumors in adolescent ovary or testicle that come from primitive sex cells

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25
Q

What is the most common cause of ovarian enlargement (5+ cm) in young women?

A

Functional cysts from normal ovarian function

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26
Q

What is PCOS

A

bilaterally enlarged polycystic ovaries with a “string of pearls appearance” PCOS is an endocrine disorder that comes from a hormone imbalance

27
Q

Who does PCOS affect and what are the symptoms

A

Women in their late teens-20s. Symptoms may be amenorrhea, obesity, infertility, hirtuism

28
Q

What is a Theca Lutein cyst and what are symptoms?

A

a large, bilateral, multiloculated functional cyst. Symptoms include elevated HCG

29
Q

What is the relation between Molar Pregnancy and Theca Lutein cysts

A

Theca lutein cysts are seen in 30% of molar pregnanies.

30
Q

What is a common cause of Ovarian Hyperstimulation Syndrome and what are the symptoms?

A

OHS is caused by a complication with fertility treatment. They may cause pain and ascites

31
Q

What are the differences in symptoms between mild and severe Ovarian Hyperstimulation Syndrome

A

Mild: enlarged ovaries <5 cm. Severe: enlarged ovaries >10 cm, thin-walled cysts, pleural effusions

32
Q

What is a para-ovarian cyst and where do they come from?

A

A simple cyst in the adnexal region and broad ligament next to the ovary that comes from remnant of Wolffian or Mullerian duct

33
Q

Who is at risk for a paraovarian cyst and what are the symptoms?

A

women from 20-40, possible torsion or bleeding but otherwise asymptomatic

34
Q

What is Diffuse Endometriosis? Is it more or less common?

A

Endometrial tissue is present outside uterus. More common than localized, but rarely diagnosed with sonography.

35
Q

What is Localized Endometrioma? Who does it affect?

A

A “chocolate cyst” that 30-40% of women develop as a result of endometriosis.

36
Q

How do “chocolate cysts” appear sonographically

A

Well-defined, cystic with posterior enhancement, homogeneous, found in multiple areas

37
Q

What is ovarian torsion? How is it identified?

A

When an ovary twists on its pedicle. the ovary has no color flow and is > 4cm.

38
Q

The right ovary is 3x more likely to have torsion.
How likely is it that an ovary will have torsion more than once?

A

Once torsion occurs, it is 10% more likely to happen again.

39
Q

1 in 70 women develop ovarian carcinoma. At what age is it most common?

A

60% between the ages of 40 and 60.

40
Q

What happens during stage I and II ovarian cancer

A

Stage one: the disease is in one or both ovaries. Stage two: it spreads to other pelvic tissues like the uterus or fallopian tubes

41
Q

What happens during stage III and IV ovarian cancer

A

Stage three: the disease spreads into the abdomen or peritoneum. Stage four: it spreads to other organs such as the liver

42
Q

What is ascites

A

hypoechoic fluid with bright echos in potential spaces

43
Q

Epithelial tumors are the most common ovarian malignancies occuring 80-90% of the time. Which kind is more common, serous or mucinous?

A

Serous is more common (30% of new growths). Mucinous is second most common (20-25% of new growths)

44
Q

What is Mucinous Cystadenoma?

A

It is 15-30 cm, unilateral, and multiloculated with thin walls

45
Q

What are the symptoms of Mucinous Cystadenoma and who does it affect?

A

It affects women 13-45 causing pressure, pain, and increase in abdomen size.

46
Q

What is Mucinous Cystadenocarcinoma?

A

Malignant, cystic, likely to rupture which leads to ascites. They may have thick, irregular walls, septations, projections, etc.

47
Q

What are the symptoms of Mucinous Cystadenocarcinoma and who does it affect?

A

Pelvic pressure and pain with rupture that affects women aged 40-70

48
Q

What is Serous Cystadenoma?

A

Usually unilateral, up to 20cm, multiloculated with and septationsirregular borders

49
Q

What are the symptoms of Serous Cystadenoma and who does it affect?

A

Pelvic pressure and bloating that affects women from 40-50

50
Q

What is Serous Cystadenocarcinoma?

A

Cyst with septations or projections, possible calcifications, ascites that may invade other organs and is more commonly bilateral.

51
Q

What are the symptoms of Serous Cystadenocarcinoma and who does it affect?

A

Pelvic fullness or bloating that usually affects women 45-65 with history/ familial history of cancer and/or tamoxifen exposure.

52
Q

What is a teratoma or dermoid tumor?

A

Most common germ cell tumor that is up to 40 cm and any size/appearance. May contain fat, hair, cartilage, bone, or teeth.

53
Q

Who do dermoid tumors affect and what are the symptoms?

A

Women of reproductive age. Pain and abdominal pressure

54
Q

What is a fibroma

A

an abundance of fibrous tissue with great variation in size, ascites with fibromas >5cm, hypoechoic mass

55
Q

When might a teratoma be malignant?

A

In older women

56
Q

Who is most at risk for fibroma and why?

A

Older women at risk, since fibroma is rarely associated with estrogen production

57
Q

What is thecoma?

A

a rate, benign, estrogen dependent post-menopausal tumor

58
Q

Meigs syndrome is a benign condition. What is it associated with?

A

ascites

59
Q

What is a granulosa

A

Neoplasm composed of cells resembling a graafian follicle. May occur woth or without torsion. similar echogenicity to uterine fibroid

60
Q

Who is affected by granulosa?

A

50% after menopause, 45% during reproductive years, 5% in adolescence.

61
Q

What is metastasis

A

Cancer that can arise from breast, upper GI tract, and other organs directly or through lymphatic spread. Frequently bilateral and associated with ascites. Solid or complex.

62
Q

What is Dysgerminoma

A

Entirely solid ovarian mass in woman under 30 years.

63
Q

What are the most common ovarian neoplasms seen in pregnancy?

A

Dysgerminoma and Serous cystadenoma

Gyn Imaging 118/119 (8 decks)

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