Disease Of Ovaries Flashcards
Disease of the ovaries
Follicular cysts
Tumors
Follicular cysts single or multiple ?
Both
Single cysts presentation
Large and associated with amenorrhea
Multiple cysts presentation
Smal and associated with endometrial hyperplasia
Type of follicles that lead to follicular cysts
Graffian follicle
Cells that line follicular cysts
Granulosa cells
Theca lutein cysts surrounded by
Luteinised granulosa cells
Pcos type of cysts
Bilateral multiple small cysts
Stein leventhal syndrome see in PCOS characteristics
Obesity
Hirsutism
Oligomenorrhea
What are chocolate cyst
Ovarian endometriosis cysts
Working classification of ovarian tumors
Epithelial tumors Sex cord/ stromal tumors Germ cell tumors Others Secondary metastatic tumors
2 types of epithelial tumors of ovary
Mature mullerian tissue
Analogous tumors
Epithelial tumors of Mature mullerian tissues types
Tubal epithelium
Endocervical epithelium
Endometrial epithelium
Transitional epithelium
Analogous tumors types
Serous
Mucinous
Endometriod
Brenners
3 types of tumors
Benign
Border line
Malignant
Benign tumors characteristics
Acini lined by single cell layer
Borderline tumors characteristics
Epithelium heaped up
Moderate nuclear atypia and mitoses
No stromal invasion
Malignant tumor characteristics
Solid epithelium
Moderate to severe atypia
Stromal invasion
Percentage of surface epithelial tumor in ovarian tumor
65-70%
Percentage of surface epithelial tumor of malignant tumor
90%
Age group surface epithelial tumor
More than 20yo
Ovarian ca concerns developed or developing societies
Developed
H what offers protection against surface epithelial tumors
OCP
Pregnancy
Risk factor
Talc to vulva
Trauma to surface epithelium
Family history (5x more sisters and mothers)
Percentage of hereditary ovaria ca
5%
Mutation leading to ovarian ca
P53 pt mutation
If erbB-2 (her-2/neu ) on top , poor prognosis
Gynecological malignancy with the most death
Ovarian carcinoma
Form of spread of ovarian tumor
predominantly intra-abdominal
Ciara marker of ovarian cancer
CA125
Serous cystadenoma ovarian tumor percentage
25
Morphology Serous cystadenoma
Cuboidal lining epithelium
Few Intracystic papillary projection
Watery fluid
Is malignant transformation common in Serous cystadenoma
Yes
Commonest malignant tumor of the ovary
Serous cystadenocarcinoma
Percentage of Serous cystadenocarcinoma out of Malignant tumors of ovary
60
Morphology of Serous cystadenocarcinoma
Exuberant papillomatosis Groves over surface of ovary which obliterate ovarian structure
D percentage mucinous cystadenoma
20% of all ovarian tumors
Morphology of mucinous cystadenoma
Multilocular pattern
Tall columnar epithelium
Gelatinous secretion
Type of tumor that can rupture and cause pseudomyxoma peritonei due to mucus secreting epithelium on the peritoneum
mucinous cystadenoma
mucinous cystadenocarcinoma % in all carcinoma of ovary
20
Morphology of mucinous cystadenocarcinoma
Florid papillary pattern in malignant areas
Percentage brenners tumor in ovarian tumor
2%
Brenners tumor morphology
Fibroblastic stroma
Island of transitional epithelium
Mucinous meta0lasia
Stromal calcification and cysts
What is Endometrioid carcinoma
Solid or semisolid tumor
Mostly arising from surface epithelium of millenarian metaplasia along endometrial lines
Is there a benign counterpart to Endometrioid carcinoma
No
Two groups of sex cord and stromal tumor
Estrogen producing
Androgen producing
Estrogen producing tumor
Granulosa cell tumor
Thecomas or fibromas
Androgen producing cell
Sertoli Leydig cell tumors
Hilus cell tumor
Lipid cell tumor
Type of cll in Granulosa cell tumor
Cell resembling Granulosa cells
Percentage of Granulosa cell tumor
2% of ovarian tumor
Morphology of Granulosa cell tumor
Micro follicle (call exner bodies) Coffee beans cells
Hormone excessively produced in Granulosa cell tumor
Estrogen
What are Thecomas
Tumor of ovarian mesenchyme
Morphology Thecomas
Unilateral Firm solid
Consequences of estrogen production
Precocious puberty
Endometrial hyperplasia
Enlargement of breast
Post menopausal bleeding
Main association to fibromas
Meigs syndrome wirh peritoneal and pleural effusion
Tumor that typifies virilising tumor group
Sertoli-Leydig cell tumor
Sertoli-Leydig cell tumor macro morphology
Small Yellow in ovary
Sertoli-Leydig cell tumor micro morphology
Tubule line day Sertoli cell
Leydig cell in stroma like testes
Androgen release consequences
Atrophy of testes External genitalia atrophy Voice deepening Facial and body hair growth Clitoris enlargement
Different ways germ cell tumor can différente
Primitive cell - dysgerminoma
Embryonic differentiation- Teratoma
Extra embryonic differentiation - yolk sac tumor , choriocarcinoma
What are dysgerminoma
Malignant
Solid tumor
dysgerminoma morpho
Large round cell with large nuclei resembling germ cells
Alveoli pattern
Fine connective tissue
Teratomas type
Mature and immature
Cystic or solid
Cystic Teratoma
Common tumor of ovary All ages Unilocular Eminence of one part with hair stratified squamous epithelium which can become malignant
Solid teratoma characteristics
Solid
Unilateral
Large
rare
What is monoplyetic Teratoa
One type of tissue
Stroma ovarii is thyroid tissue
Carcinoid tumor seen in ovary
Highly malignant tumor of women under 30yo
Yolk sac tumor
Histology of yolk sac tumor
Resemble mesenchyme of primitive yolk sac
Second most common malignant germ cell tumor
Yolk sac tumor
Morphology of yolk sac tumor
Large
extensive necrosis and hemorrhage
Reticular honeycombed structure of communicating species lined by primitive cells
Schiller duval bodies
Regarde are Schiller duval bodies
Papillae that protrudes into space lined by tumor cells and contai; fibrovascular core
Protein secreted by yolk sac tumor
A-fetoprotein seen I pin eosinophilic droplets
Prognosis for yolk sac tumor
Good nowadays due to chemotherapy
Exceed 80% 5ysr
Staging of ovarian cancer
What is choriocarcinoma
Secretes hcg highly metastatic
Similar to gestational choriocarcinoma
Secondary tumor of ovaries which is Adenocarcinoma from stomach or large intestine
Krukenberg tumor
Characteristics of krukenberg tumor
Mucous secretion
Signet ring cell
Bilateral
Lymphomas of the ovaries, primary or secondary
Both
Burkitt lymphoma of ovaries primary or secondary
Primary