Exam #2 Flashcards
Pathology of the Uterus, Ovaries, Adnexa & ART (Assisted Reproductive Technology
what are the four functional types of follicles?
- functional
- corpus luteum
- hemorrhagic
- theca lutein
What is PCOS?
Polycystic Ovarian Syndrome
- a hormonal imbalance:
- excess of LH
- difficulty developing dominant follicle
how does PCOS present sonographically?
- *string of pearls
how does a teratoma look sonographically?
- echogenic linear strands for hair
- hyperechoic areas MAY BE fat
- complex with cystic and solid components
- *tip of the iceberg (bone show as a hyperechoic area w. posterior shadowing)
what is a fibroid?
a benign muscular tumor
name the types of fibroids?
- subserosal
- submucosal
- intramural
- intracavitary
- pedunculated
what is endometriosis?
ectopic endometrial tissue
what is a pseudomyxoma peritoneum?
- very rare cancer that affects peritoneal cavity
- starts w/ a cancerous polyp in appendix. when it breaks free it triggers a flow of cancer cells that produce mucin, which overtime affect digestive system.
- however, in female pelvis, it starts with a mucinous tumor in the ovary
- assoc. w. the rupture of a mucinous cystadenocarcinoma
Meig’s syndrome
- triad of a benign tumor
- ascites
- pleural effusion
- seen w. a benign tumor, most often a fibroma
Arteriovenous malformation
AVM
Endometritis
inflammation of the endometrium
Endometrial hyperplasia
overgrowth of the endometrium due to hormones, cancer, etc..
Parametritis
infection of the uterine serosa and broad ligament(s)
Peritonitis
inflammation of the peritoneum
What is the difference between an immature and a mature teratoma (dermoid)?
- immature teratoma: malignant, common in young girls (age 10-20)
- mature teratoma: (dermoid) benign, 95% of germ cell ovarian tumors
What are the two most common epithelial tumors?
- serous
- mucinous
What are the two most common benign ovarian tumors?
(hint: T & S)
- teratoma (dermoid)
- serous cystadenoma
What are the two most deadly cancerous ovarian tumors?
(hint: S & M)
- serous cystadenocarcinoma
- mucinous cystadenocarcinoma
What are benefits of progesterone and estrogen?
- progesterone: prevents endometrial overgrowth
- estrogen: protects against heart disease, osteoporosis, and hot flashes
What are the risks of progesterone and estrogen?
- progesterone: may increase risk of breast cancer
- estrogen: increases risk for endometrial hyperplasia and cancer
What is an Arrhenoblastoma? What are the side effects?
a.k.a. a sertoli leydig tumor
- produce excess of androgens causing signs of masculinization
What is the metastatic tumor that forms on the ovary?
- Krukenberg tumor
- originates from the GI tract/stomach
What is ART? What is its purpose and how does it work?
- Assisted Reproductive Technology
- helps people conceive when they are unable to do so naturally
IVF?
In Vitro Fertilization
GIFT
Gamete Intrafallopian Transfer
Zift?
Zygote Intrafallopian Transfer
Gamete?
Egg and sperm
IUI?
Intrauterine insemination
- sperm injected directly into the uterus
Ovarian torsion
- twisting of ovary
- causes an enlarged, edematous appearance with no blood flow
- A SURGICAL EMERGENCY
Arteriovenous malformation
medical terms: pyo
pus
medical terms: metro
uterus
medical terms: colpos
vagina
medical terms: hemat
blood
medical terms: salping
fallopian tube
medical terms: hydrosalpinx
fluid blockage in fallopian tube(s)
medical terms: salpingitis
inflammation of the fallopian tube
medical terms: hematosalpinx
blood in the fallopian tube
What is PID?
Pelvic Inflammatory Disease
What are the most common causes of PID?
- early sexual activity
- multiple partners
- IUD issues
- non-sterile instrumentation
Why is it difficult to differentiate PID from endometriosis or bowel pain?
all three present with similar/overlapping symptoms, which varies with intensity and timing, making it hard to tell difference without further investigation
T/F: PID can cause TOA or a TO Complex.
True
What are polyps?
- benign overgrowth endometrial glands, stroma, & blood vessels
Hysterosonogram
- a.k.a SIS (saline infusion sonogram)
- locate any abnormalities within uterus
Fritz-Hugh Curtis Syndrome: What is it? How does it present?
- perihepatic adhesions caused from severe PID infection
- symptoms: pain when coughing/laughing (adhesions pulling)
What are the risks of ART?
- multiple births
- EP
- overstimulated ovaries resulting in OHSS.
OHSS
Ovarian Hyperstimulation Syndrome
What is Perignol and Clomid?
medications used to stimulate the ovaries
What are the different types of IUD? What are they made of?
- Paraguard (copper) last 10 years
- Mirena (hormonal/progestin) lasts 5-6 years
- Skyla (hormonal) lasts 3-4 years
How do different IUDs present sonographically?
- Paraguard: highly echogenic, posterior shadowing
- Mirena: harder to see, may stop periods
What are some options for birth control?
- Essure
- IUD’s
- Nuva Ring
- Implanon
Birth control: Essure
- permanent
- placed in fallopian tubes
- causes scarring
Birth control: Birth control: Nuva Ring
- vaginal hormonal ring
Birth control: Implanon
- hormone implant in the arm
Birth control: Depo-Provera Shot
- injection every 3 months
- used in menopausal hormone therapy
adenomyosis
*spec. in uterine wall
- endometrial tissue grows in myometrium
endometrioma
*spec. on the ovary
- a.k.a “chocolate” cyst
- endometrial tissue on ovary
What are the classifications of ovarian tumors?
- epithelial cell tumor
- germ cell tumors
- sex cord stromal cell tumors
- metastases from other organs
epithelial cell tumor
- cells that line an organ
- 80% of ov tumors
germ cell tumors
- cells that produce the ova
- 15% of ov tumors
sex cord stromal cell tumors
- cells that release hormones
- ct cells that hold ovary together
- 5-10% of ov tumors
What are some benign ovarian tumors? What classification category do they belong to?
(hint: 8 ex.)
- teratoma (dermoid): germ cell
- serous cystadenoma: epithelial
- mucinous cystadenoma: epithelial
- brenner tumor: epithelial
- fibroma: sex cord (made of ovarian stroma)
- thecoma; sex cord (formed by theca cell - ovarian stroma cells)
- sertoli-leydig cell tumors or androblastoma/arrenhoblastoma (sex cell)
- granulosa-theca cell tumor: sex cord or stromal tumor
what is the most common and second most common benign tumor?
1st: teratoma (dermoid)
2nd: serous cystadenoma
What is the most common hormone tumor?
granulosa-theca cell tumor
What are some malignant ovarian tumors? (hint: 5)
- serous cystadenocarcinoma (epithelial
- mucinous cysadenocarcinoma (epithelial)
- dysgerminoma germ cell: cells identical to male xeminoma)
- endodermal sinus tumor: a.k.a yolk sac tumor (germ cell)
- immature teratoma (germ cell)
__% of women who have common epithelial ovarian cancer are not diagnosed until ___
- 70%
- disease is advanced in stage
Borderline tumors or low malignant potential tumors
- abnormal cell growth that is not fully cancerous but has the potential to become
- mostly seen in ovaries
__% of patients with ovarian gem cell malignancies can be ___
- 90%
- can be cured and have their fertility preserved
stroma tumors are considered ___ grade cancers. –% present as stage __ disease
- low grade
- 70%
- I (cancer limited to one or both ovaries)
Primary Peritoneal Carcinoma
develops from the peritoneum (abdomen lining)
Sonographic finds: Serous Cystadenoma
- unilocular and anechoic
- look like a simple cyst
Sonographic finds: Mucinous Cystadenoma
- multilocular (may contain complex fluid) with thin septations
- papillary projections raises suspicion of a possible bordeline malignancy
Why would a mucinous cystadenoma contain complex fluid?
due to proteinaceous debris or hemorrhage, or both.
Sonographic finds: Brenner Tumor
- shadowing hypoechoic mass with punctuate echogenic foci
Sonographic finds: Fibroma
- solid, hypoechoic mass
- may appear similar to a peduncul;ated subserosal uterine fibroid
Sonographic finds: Serous cystadenocarcinoma
- multilocular with papillary projections
- other presentations: cystic with thick septations
- hypervascularity: complex, large mass with a cystic component
Sonographic finds: Krukenberg Ovarian tumor
- tumor mass next to a small bowel loop
