Female GU Pathology III: Ovary and Fallopian Tube Flashcards
Follicular Cysts
Result from unruptured Graafian follicles or ruptured follicle that immediately seals.
Corpus luteum cysts
Result from delayed resolution of a corpus luteum’s central cavity - hemorrhage into a corpus luteum may result in hemorrhagic corpus luteum cyst
Polycystic Ovarian Syndrome
Excess secretion of androgens due to increased LH cause anovulation leading to ovarian cysts and enlarged ovaries
What is the action of LH?
LH stimulates theca cells to produce androgens
What is PCOS associated with?
Increased insulin resistance and T2 diabetes
Androgen is converted in adipose tissue to estrone resulting in what long‐term potential complication of PCOS?
A. Cervical squamous cell cancer
B. Uterine endometrioid endometrial cancer
C. Uterine serous papillary endometrial cancer
D. Leiomyosarcoma of uterus
B. Uterine endometrioid endometrial cancer
What are some symptoms of PCOS?
- Hirsutism
- Virilism
- Acne
How does obesity cause estrogen excess?
Androgens are converted to estrone in the adipose tissue
What are seem therapies for PCOS?
- Weight Loss
- Metformin
What is the most common ovarian tumor?
Surface Epithelial Tumors
What are the 2 types of surface epithelial tumors?
- Serous
- Mucinous
- Cyst with thin and smooth surface
- Single layer of lining cells similar to that of fallopian tube mucosa
- No cytologic atypic
- No invasion
Benign Serous Cystadenoma
- Papillary structures with destructive stromal invasion
- May have presence of psamomma bodies
Serous Cystadenocarcinoma
What is the most common type of surface epithelial tumor?
Serous
- Multiple cystic mass filled by sticky, gelatinous fluid
- Lining epithelium single row of uniform mucin-filled columnar cells with basal nuclei.
- Absent or minimal cellular stratification, no or minimal cellular atypia
Mucinous Cystadenoma
- Destructive stromal invasion, cytologic atypic and filled by sticky, gelatinous fluid
Mucinous Cystadenocarcinoma
What are some risk factors for cystadenocarcinomas?
- Nulliparity
- Family Hx
What tumor marker is used to monitor therapy response in cystadenocarcinomas?
CA‐125
Borderline Tumors
• Morphology and behavior “in between” benign and malignant
• Limited invasive potential
• Better prognosis than overtly malignant
carcinomas
Who are germ cell tumors often seen in?
Most common ovarian cancer in children and adolescent females
Teratoma
Tumor of germ cell origin that is differentiated embryonic tissue and is comprised of more than one neoplastic cell type
- Comprise 90% of all teratomas
* Derive from all germ layers – Ectoderm, Endoderm, Mesoderm
Benign Mature Teratoma
Struma Ovarii
A large amount of ovary is thyroid tissue
Malignant Teratoma
VERY rare - only 1% of all teratomas and have some malignant component -> SCC/thyroid carcinoma/melanoma
- Uncommon tumor, composed of mature and immature (primitive cells) embryonal type tissues
- Most commonly diagnosed in prepubertal girls, adolescents and young woman
- Rapidly growing tumor with frequent capsular rupture
Immature Teratoma
- Ovarian counterpart of the testicular seminoma
- Most common malignant germ cell tumor of ovary
- LDH tumor marker
Dysgerminoma
What germ cell tumor is radiosensitive?
Dysgerminoma
With what germ cell tumor are Schiller‐Duvall Bodies seen?
Endodermal Sinus Tumor
Histology
- Large cells with clear cytoplasm
- Stroma with lymphocytes
Dysgerminoma
- Neoplasm attempts to recapitulate placental tissue; trophoblasts and syncystiotrophoblasts without chorionic villi
- hCG tumor marker
Choriocarcinoma
What tumor has AFP as a marker?
Endodermal Sinus Tumor
What class of ovarian tumors has these features:
• Originate from undifferentiated gonadal mesenchyme
• Any age
• Most benign, low malignant potential
• Hormonally active
Sex‐Cord Stromal Tumors
Most common ovarian tumor with estrogen production.
Granulosa Cell Tumor
This tumor is associated with androgen production and tends to be virilizing.
Leydig Cell Tumor
‐ Fibroblasts (fibroma)
‐ Lipid‐laden theca cells (theca)
- May produce estrogen
Thecoma-Fibroma
What tumor is associated with Meigs Syndrome?
Thecoma-Fibroma
What are the features of Meigs Syndrome?
‐ Right sided pleural effusions
‐ Ascites
‐ Ovarian mass
Call-Exner Bodies
Gland like structures filled with eosinophilic material seen in granulosa cell tumors
- Metastatic mucinous tumor to both ovaries
- Most commonly gastric carcinoma origin
Krukenberg Tumor
A 60‐year‐old woman presented with diffuse abdominal pain and distension of the abdomen. Evaluation revealed disseminated gelatinous ascites and multifocal peritoneal epithelial implants, secreting copious globules of extracellular mucin. Which of the following should be at the top of the differential diagnosis with respect to underling cause of her condition?
A. Gastric carcinoid; ovarian serous cystadenoma
B. Appendiceal carcinoid; ovarian serous cystadenocarcinoma
C. Appendiceal mucinous cystadenoma; ovarian Brenner tumor
D. Appendiceal mucinous cystadenocarcinoma; ovarian mutinous cystadenocarcinoma
E. Gastric GIST; ovarian mucinous cystadenoma
D. Appendiceal mucinous cystadenocarcinoma; ovarian mutinous cystadenocarcinoma
Pseudomyxoma peritonii
Extensive intraperitoneal mucous
Acute Salpingitis
Ascending sexually transmitted; most common organisms: Gonococcus and Chlamydia
