Fallopian Tubes and Ovaries

Question 1

Describe the anatomy of the fallopian tubes

Answer 1

• Lined by ciliated columnar epithelium with complex plicae, layers of smooth muscle and peritoneum

Question 2

What are the features of salpingitis?

Answer 2

• Mainly bacterial (Chlamydia trachomatis, Mycoplasma, coliforms, Streptococci, Spaphylococci, Neisseria gonorrheae)
• Presents with fever, lower abdominal/pelvic pain and pelvic masses
• Complications include adherence of tube to ovary and tubo-ovarian abscesses

Question 3

Describe the anatomy of the ovaries

Answer 3

• Flat surface epithelium
• Cortex has compact ovarian stroma, small functional cysts and germ cells
• Medulla has hilus cells, vessels and nerves

Question 4

What are the features of non-neoplastic ovarian cysts?

Answer 4

• Include inclusion, follicular and luteal
• Cause oligomenorrhea, hirsuitism, infertility and obesity - usually after menarche
• Thickened, fibrotic outer surface, over cysts lined by granulosa cells with hypertrophic and hyperplastic luteinized thica interna

Question 5

What are the three cell types that ovarian tumours are related to?

Answer 5

• Surface (coelomic) epithelium
• Germ cell
• Sex cord/stromal cells

Question 6

What are the risk factors for epithelial ovarian cancers?

Answer 6

• Nulliparity and family history

- Some related to BRCA1 and BRCA2 mutations

Question 7

List types of malignant epithelial tumours

Answer 7

• Cystadenocarcinoma
• Adenocarcinoma
• High grade serous
• Endometrioid
• Clear cell
• Low grade serous
• Mucinous

Question 8

Describe serous ovarian tumours

Answer 8

• Smooth shiny serosal covering
• Cysts filled with clear serous fluid, lined by a single layer of tall columnar epithelium
• Some cells ciliated

Question 9

Describe mucinous ovarian tumours

Answer 9

• Consist of mucin-secreting cells
• Metastases to the ovary from GI tract can mimic these
• Large, multiocular, no psammoma bodies

Question 10

Describe ovarian endometrioid carcinoma

Answer 10

• Characterised by neoplastic tubular glands
• Most are low grade and arise from endometriosis
• Most have lost the PTEN TSG

Question 11

Describe ovarian germ cell tumours

Answer 11

• Smooth capsule, often filled with sebaceous secretion and matted hair
• Sometimes, foci of bone and cartilage, nests of bronchial or GI epithelium, teeth and other recognisable lines of development

Question 12

Describe Brenner tumours

Answer 12

• Mixed surface epithelial-stromal tumours
• Usually benign, unilateral, size very variable, solid, circumscribed and yellowish
• Nests of transitional epithelial cells with longitudinal nuclear grooves and abundant fibrous stroma