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Female Pathology Flashcards

1
Q

The two most important etiologies of PCOS are _ and _

A

The two most important etiologies of PCOS are increase in adipose tissue and increased LH

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2
Q

What is the consequence of increased adipose tissue in PCOS?

A

Increased adipose –> Increased estrogen –> Increased insulin resistance

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3
Q

What is the consequence of high LH in PCOS?

A

High LH –> disrupts the LH/FSH balance –> anovulation –> cyst formation

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4
Q

PCOS is also associated with an increase in androgen production by _ cells

A

PCOS is also associated with an increase in androgen production by ovarian theca interna cells

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5
Q

Explain how PCOS causes an increase in the free estrogens and androgens

A

PCOS is associated with insulin resistance –> this disrupts normal liver function –> decrease in sex hormone binding globulin –> increase in free estrogens and androgens

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6
Q

PCOS is associated with _ levels of estrogen and _ levels of progesterone

A

PCOS is associated with high estrogen and low progesterone

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7
Q

High estrogen and low progesterone causes _ to occur in PCOS

A

High estrogen and low progesterone causes endometrial hyperplasia to occur in PCOS

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8
Q

What is the “triad” of PCOS sx?

A
  1. Insulin resistance: obesity, acanthosis nigricans
  2. Increased estrogen, low progesterone: amenorrhea/oligomenorrhea, enlarged ovaries, infertility
  3. Increased androgens: hirsutism, acne
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9
Q

Though both LH and FSH are elevated in PCOS, (LH/FSH) are highest

A

Though both LH and FSH are elevated in PCOS, LH levels are highest

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10
Q

PCOS lab findings:

A

PCOS lab findings:
* High LH (very)
* High FSH
* High estrogen
* High testosterone

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11
Q

PCOS will appear as _ on ultrasound

A

PCOS will appear as enlarged ovaries with multiple cysts on ultrasound
* “String of pearls”

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12
Q

Hormonal contraceptives are often prescribed in the setting of PCOS for the purpose of _

A

Hormonal contraceptives are often prescribed in the setting of PCOS for the purpose of establishing estrogen/progesterone balance
* Prevent endometrial hyperplasia due to unopposed estrogen

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13
Q

Weight loss and metformin may be prescribed in the setting of PCOS to _

A

Weight loss and metformin may be prescribed in the setting of PCOS to decrease adipose tissue

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14
Q

Why is spironolactone used in for PCOS?

A

Spironolactone can be used as a steroid receptor antagonist –> androgen blocking effects

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15
Q

Finasteride inhibits _ which decreases the conversion of testosterone to DHT

A

Finasteride inhibits 5-alpha-reductase which decreases the conversion of testosterone to DHT

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16
Q

Letrozole is used for PCOS because it blocks the conversion of _ to _

A

Letrozole is used for PCOS because it blocks the conversion of androstenedione to estrone

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17
Q

Flutamide works as a _ and can be used in PCOS

A

Flutamide works as a androgen receptor antagonist and can be used in PCOS
* Can treat hirsutism

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18
Q

_ is a drug that promotes ovulation and may be used in the setting of PCOS

A

Clomiphene is a drug that promotes ovulation and may be used in the setting of PCOS
* Selective estrogen receptor modulator

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19
Q

Adenomyosis is _

A

Adenomyosis is hyperplasia of the endometrial basalis layer

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20
Q

The endometrium is composed of two “layers” the _ and the _

A

The endometrium is composed of two “layers” the stratum basalis and the stratum functionalis

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21
Q

Adenomyosis occurs when there is hyperplasia of the basalis layer that leads to invasion of endometrial tissue into the _

A

Adenomyosis occurs when there is hyperplasia of the basalis layer that leads to invasion of endometrial tissue into the myometrium

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22
Q

Adenomyosis is most likely to occur in women who have high _ levels

A

Adenomyosis is most likely to occur in women who have high estrogen levels
* Ex: PCOS, hormone replacement therapy, ovarian producing tumors
* Women aged 30-50

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23
Q

Describe the uterus in adenomyosis

A

Describe the uterus in adenomyosis:
soft, boggy, uniformly enlarged globular uterus
* May or may not present with tenderness

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24
Q

Adenomyosis may present with _ (painful periods) or _ (heavy or prolonged bleeding)

A

Adenomyosis may present with dysmenorrhea (painful periods) or menorrhagia (heavy or prolonged bleeding)

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25
Q

Adenomyosis can be treated with medication like _ or hysterectomy

A

Adenomyosis can be treated with medication like GnRH agonists (leuprolide) or hysterectomy

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26
Q

When high levels of estrogen cause enlargement of the endometrial glandular tissue we call this _

A

When high levels of estrogen cause enlargement of the endometrial glandular tissue we call this endometrial hyperplasia
* Increased estrogen relative to progesterone
* More common after menopause
* Causes AUB
* Diagnose with US and endometrial biopsy

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27
Q

What are the etiologies of endometrial hyperplasia?

A

Endometrial hyperplasia is caused by high-estrogen states:
* PCOS
* Estrogen supplementation
* Nulliparity
* Late menopause
* Estrogen producing tumors

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28
Q

Endometrial hyperplasia may present as _

A

Endometrial hyperplasia may present as abnormal uterine bleeding or post menopausal bleeding

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29
Q

Endometrial hyperplasia can be identified as _ on histology

A

Endometrial hyperplasia can be identified as proliferation of glandular cells with atypical cells showing extensive loss of cell polarity

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30
Q

Endometrial hyperplasia can be medically managed with _ or hysterectomy if evidence of cellular atypia on biopsy

A

Endometrial hyperplasia can be medically managed with progesterone (progestin) supplementation or hysterectomy if evidence of cellular atypia on biopsy
* The idea behind giving progesterone is to improve hormone balance

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31
Q

Asherman syndrome is _

A

Asherman syndrome is failure of the endometrium to regenerate following uterine trauma

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32
Q

Explain the pathogenesis of Asherman syndrome

A

Uterine trauma –> destruction of the endometrial basalis layer –> adhesions/fibrosis –> failure of endometrial regeneration

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33
Q

Asherman syndrome may present as _

A

Asherman syndrome may present as amenorrhea, infertility, abnormal uterine bleeding, pelvic pain, recurrent pregnancy loss

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34
Q

The deepest layer of the endometrium is the _ , the more superficial layer of the endometrium before the myometrium is the _

A

The deepest layer of the endometrium is the stratum functionalis (gets shed) , the more superficial layer of the endometrium before the myometrium is the stratum basalis (regenerates)

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35
Q

Endometriosis is _

A

Endometriosis is extrauterine endometrial tissue

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36
Q

Overall the most common location for endometriosis is _ ; others include:

A

Overall the most common location for endometriosis is the ovaries ; others include: uterosacral ligaments, rectouterine pouch peritoneum

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37
Q

A predominant theory for the etiology of endometriosis is _

A

A predominant theory for the etiology of endometriosis is retrograde blood/ lymphatic flow

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38
Q

Endometriosis may present with _ (painful periods), _ (pain with sex), _ (difficulty pooping), and cyclic pelvic pain

A

Endometriosis may present with dysmenorrhea (painful periods), dyspareunia (pain with sex), dyschezia (difficulty pooping), and cyclic pelvic pain
* Can also cause infertility, abnormal uterine bleeding

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39
Q

Endometriosis can be visualized on ultrasound and may show a normal sized retroverted uterus with _

A

Endometriosis can be visualized on ultrasound and may show a normal sized retroverted uterus with nodular adnexa

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40
Q

Surgical pathology may reveal _ lesions of the peritoneum from endometriosis

A

Surgical pathology may reveal yellow-brown “powder burn” lesions of the peritoneum from endometriosis

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41
Q

Cystic, fluid filled lesions may result from endometriosis; we call this _

A

Cystic, fluid filled lesions may result from endometriosis; we call this endometrioma

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42
Q

Blood filled “chocolate cysts” on the ovaries is indicative of _

A

Blood filled “chocolate cysts” on the ovaries is indicative of endometrioma (endometriosis)

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43
Q

How do we manage endometriosis?

A

How do we manage endometriosis?
* NSAIDs (pain control)
* OCPs (inhibit LH surge –> decrease hormone fluctuation)
* GnRH agonists ie leuprolide (decrease LH/FSH)
* Progestins (suppress growth and implantation of ectopic endometrium)
* Danazol (inhibit LH/FSH surge)
* Surgical removal

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44
Q

Endometritis is _

A

Endometritis is inflammation/ infection of the endometrial lining from retained uterine contents
* Often occurs postpartum, after miscarriage, abortion, IUD, multiple cervical exams

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45
Q

Endometritis may present with:

A

Endometritis may present with:
* Fever, vaginal discharge, abdominal pain, uterine tenderness, foul smelling lochia (postpartum discharge)

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46
Q

Complications of endometritis include:

A

Complications of endometritis include: sepsis, surgical site infection, peritonitis

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47
Q

Acute endometritis is often caused by _ (pathogen)

A

Acute endometritis is often caused by group B streptococcus

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48
Q

Chronic endometritis is often caused by growth of _ or _

A

Chronic endometritis is often caused by growth of N. gonorrhoeae or A. israelii
* Also caused by chlamydia, IUD, TB

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49
Q

Endometriosis is the presence of estrogen-sensitive _ and _ outside of the uterine corpus

A

Endometriosis is the presence of estrogen-sensitive glands and stroma outside of the uterine corpus
* It responds to physiologic estrogen and continues to grow and bleed resulting in chronic inflammatory disorder

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50
Q

How does endometriosis present clinically?

A

Endometriosis may present with:
* Adnexal mass
* Infertility
* Dysmenorrhea
* Dyspareunia
* Dyschezia
* Chronic pelvic pain

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51
Q

Endometritis can be diagnosed via:

A
  • Clinical suspicion: pelvic pain, fever
  • Blood cultures
  • Endometrial biopsy: inflammatory cells in the endometrium
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52
Q

On endometrial biopsy, acute endometritis will reveal _ cells

A

On endometrial biopsy, acute endometritis will reveal neutrophils

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53
Q

On endometrial biopsy, chronic endometritis will reveal _ cells

A

On endometrial biopsy, chronic endometritis will reveal plasma cells

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54
Q

Endometrial hyperplasia has a risk for progression to _

A

Endometrial hyperplasia has a risk for progression to endometrial cancer

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55
Q

Endometrial hyperplasia is associated with a gland: stroma ratio _

A

Endometrial hyperplasia is associated with a gland: stroma ratio > 1:1

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56
Q

The most common benign tumor of the urogenital tract is _

A

The most common benign tumor of the urogenital tract is leiomyoma
* Most common in premenopausal patients

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57
Q

Leiomyomas may present with:

A

Leiomyomas may present with:
* Abnormal menstruation
* Mass effect
* Urinary tract symptoms
* Infertility

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58
Q

Medical management of leiomyomas:

A
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59
Q

A benign “well circumscribed white tan firm mass with whorled appearance” describes _

A

A benign “well circumscribed white tan firm mass with whorled appearance” describes leiomyomas

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60
Q

Microscopically, leiomyomas have bland smooth muscle arranged in bundles with _ nuclei

A

Microscopically, leiomyomas have bland smooth muscle arranged in bundles with cigar-shaped nuclei

61
Q

_ is the most common cancer of the female reproductive tract

A

Endometrial cancer is the most common cancer of the female reproductive tract
* 75% of cases are postmenopausal patients

62
Q

Risk factors for endometrial cancer involve _

A

Risk factors for endometrial cancer involve chronic estrogen exposure
* Early menarche
* Late menopause
* Estrogen replacement therapy without compensatory progesterone
* Obesity
* Nulliparity

63
Q

75% of endometrial cancers are type 1 which are _

A

75% of endometrial cancers are type 1 which are endometrioid adenocarcinomas

64
Q

(Type 1/ Type 2) endometrial cancer is well-differentiated with favorable prognosis and often caught at a lower stage

A

Type 1 endometrial cancer is well-differentiated with favorable prognosis and often caught at a lower stage

65
Q

Type 1 endometrial cancers are often caused by unopposed estrogen and mutations in _ or _ tumor suppressor genes

A

Type 1 endometrial cancers are often caused by unopposed estrogen and mutations in PTEN or KRAS tumor suppressor genes

66
Q

The most common Type 2 endometrial cancers are _ and _

A

The most common Type 2 endometrial cancers are serous and clear cell
* Type 2 only make up 20% of all endometrial cancers

67
Q

Type 2 endometrial cancers are more aggressive, higher stage/grade and associated with _ mutations

A

Type 2 endometrial cancers are more aggressive, higher stage/grade and associated with TP53 mutations

68
Q

(Leiomyosarcoma/ Leiomyoma) is more common in post-menopausal women

A

Leiomyosarcoma is more common in post-menopausal women

69
Q

Risk factors of cervical cancer:

A

Risk factors of cervical cancer:
* HPV infection
* Diethystillbestrol (DES) exposure
* Smoking
* Immunocompromised state

Pap screening allows detection of dysplasia before progression to cancer

70
Q

How are abnormal cells on pap test graded?

A

ASCUS: atypical squamous cells of undetermined significance
LSIL: low-grade squamous intraepithelial lesion
HSIL: high-grade squamous intraepithelial lesion

71
Q

HPV high risk testing is screening for subtypes _ and _

A

HPV high risk testing is screening for subtypes 16,18
* Both of these make E6 and E7 gene products

72
Q

E6 inhibits _
E7 inhibits _

A

E6 inhibits TP53
E7 inhibits pRb

73
Q

High-grade squamous intraepithelial lesion (HSIL) has _ abnormalities due to increased DNA from HPV integration

A

High-grade squamous intraepithelial lesion (HSIL) has high nuclear to cytoplasm ratios abnormalities due to increased DNA from HPV integration

74
Q
A
75
Q

The vaccine used in the US to protect against HPV is _

A

The vaccine used in the US to protect against HPV is Gardasil 9
* HPV 6, 11, 16, 18, 31, 33, 45, 52, 58

76
Q

LEEP procedure is _

A

LEEP procedure is loop electrosurgical excision procedure
* This is a local procedure

77
Q

Follicular cysts are common ovarian cysts which arise from _ cells

A

Follicular cysts are common ovarian cysts which arise from sex cord/stromal cells (ie the granulosa/theca cells)
* Most common type
* Unruptured follicle

78
Q

Epithelial cysts are ovarian cysts that arise from the _

A

Epithelial cysts are ovarian cysts that arise from the surface epithelium

79
Q

_ cysts are caused by large amounts of hCG

A

Theca lutein cysts are caused by large amounts of hCG
* Cyst wall is composed of luteinized theca cells (no granulosa cells)
* Elevated androgen levels
* Tend to be bilateral

80
Q

Neoplastic cysts are malignant or benign ovarian tumors most commonly of _ origin

A

Neoplastic cysts are malignant or benign ovarian tumors most commonly of surface epithelial origin

81
Q
A

Corpus luteum cyst
Epithelial ovarian cyst

82
Q

_ is a benign cystic ovarian epithelial neoplasm with smooth external surface

A

Cystadenoma is a benign cystic ovarian epithelial neoplasm with smooth external surface
* The most common ovarian neoplasm in all ages

83
Q

Cancer antigen marker _ is used in postmenopausal patients to evaluate for ovarian cancer (recurrence)

A

Cancer antigen marker CA-125 is used in postmenopausal patients to evaluate for ovarian cancer (recurrence)

84
Q

PCOS is defined as having at least 2/3 of the following:

A

PCOS is defined as having at least 2/3 of the following:
1. Polycystic ovaries (follicular cysts)
2. Irregular menstruation/ infertility
3. Elevated androgen levels

85
Q

PCOS pathophysiology

A
86
Q

Ovarian cancer may present with non-specific symptoms like:

A

Ovarian cancer may present with non-specific symptoms like:
* Constipation
* Abdominal/pelvic pain
* Bloating

87
Q

Three categories/ “layers” of ovarian tumors:

A

Three categories/ “layers” of ovarian tumors:
1. Epithelial
2. Sex cord stromal
3. Germ cell

88
Q

The vast majority (95%) of ovarian neoplasms are of _ origin

A

The vast majority (95%) of ovarian neoplasms are of epithelial origin

89
Q

_ is the most common histological subtype of epithelial neoplasms

A

Serous is the most common histological subtype of epithelial neoplasms

90
Q

Serous carcinoma is associated with _ gene mutations

A

Serous carcinoma is associated with TP53, BRCA1, BRCA2

91
Q

Benign ovarian epithelial tumors are called _
Malignant tumors are called _

A

Benign ovarian epithelial tumors are called cystadenoma
Malignant tumors are called cystadenocarcinoma

92
Q

Serous (ovarian epithelial) tumors are characterized by _

A

Serous (ovarian epithelial) tumors are characterized by secretion of thin serous fluid and CA-125

93
Q
A

Serous cystadenocarcinoma

94
Q

Mucinous (ovarian epithelial) tumors are characterized by _

A

Mucinous (ovarian epithelial) tumors are characterized by thick mucus and secretion of carcinoembryonic antigen (CEA)

95
Q
A

Mucinous ovarian tumor

96
Q
A

Clear cell carcinoma
* Almost always malignant

97
Q

Sex cord tumors come from _ cells

A

Sex cord tumors come from granulosa cells

98
Q

Stromal tumors come from _ cells

A

Stromal tumors come from fibroblasts and theca cells

99
Q

(Fibromas/thecomas) produce estrogen

A

Thecomas produce estrogen
* Thecomas are a benign sex cord stromal tumor in postmenopausal women

100
Q

Meigs syndrome (3) elements

A

Meigs syndrome (3):
1. Ovarian fibroma
2. Ascites
3. Pleural effusion

101
Q

Granulosa cell tumors are malignant and will overproduce _ and _

A

Granulosa cell tumors are malignant and will overproduce estrogen and inhibin
* Postmenopausal bleeding in women in 50s

102
Q

Sertoli-leydig tumors secrete _

A

Sertoli-leydig tumors secrete testosterone –> abrupt and rapid virulization

103
Q

Germ cell tumors arise from cells that make up the _

A

Germ cell tumors arise from cells that make up the ovum
* Teratomas
* Dysgerminomas
* Yolk sac tumors
* Choriocarcinomas

104
Q

_ is a germ cell tumor that occurs most often in adolescent patients, increases serum LDH, and has fried egg appearance on histology

A

Dysgerminoma is a germ cell tumor that occurs most often in adolescent patients, increases serum LDH, and has fried egg appearance on histology

105
Q

Yolk sac tumors secrete _ and are characterized by _ bodies on histology

A

Yolk sac tumors secrete alpha-fetoprotein and are characterized by Schiller-Duval bodies on histology

106
Q
A

Teratoma

107
Q

(Mature/Immature) teratomas are benign

A

Mature teratomas are benign –> called “dermoid cyst”
* Immature are malignant

108
Q

Teratomas are _

A

Teratomas are differentiated cells of one or more 3 germ layers
* Endoderm, mesoderm, ectoderm

109
Q

_ is a mature cystic teratoma that contains predominantly thyroid tissue

A

Struma ovarii is a mature cystic teratoma that contains predominantly thyroid tissue –> hyperthyroidism

110
Q

The most common immature tissue in an immature (malignant teratoma) is _

A

The most common immature tissue in an immature (malignant teratoma) is neural

111
Q

An enlarged, asymmetric, nontender uterus in the setting of abnormal uterine bleeding is indicative of _

A

An enlarged, asymmetric, nontender uterus in the setting of abnormal uterine bleeding is indicative of leiomyoma (fibroid)
* Females aged 20-40
* Multiple discrete tumors with “whorled well-demarcated smooth muscle bundles”

112
Q

Prolonged estrogen exposure leading to discrete collection of benign endometrial tissue describes _

A

Prolonged estrogen exposure leading to discrete collection of benign endometrial tissue describes endometrial (uterine) polyps
* Most common in post-menopausal women with history of estrogen exposure

113
Q

Explain the pathophysiology of endometrial polyps

A

High estrogen –> increased growth of the uterine myometrium –> benign smooth muscle tumor

114
Q

_ is a malignant neoplasm of the myometrium which presents as a single tumor with areas of necrosis

A

Leiomyosarcoma is a malignant neoplasm of the myometrium which presents as a single tumor with areas of necrosis

115
Q

Endometrial carcinoma can be distinguished into two histological subtypes _ and _

A

Endometrial carcinoma can be distinguished into two histological subtypes endometriod type and serous type

116
Q

Endometrial atrophy that undergoes transformation describes (endometrioid/serous) type endometrial carcinoma

A

Endometrial atrophy that undergoes transformation describes serous type endometrial carcinoma

117
Q

Histology of serous type endometrial carcinoma will show _

A

Histology of serous type endometrial carcinoma will show papillae, tufts +/- psammoma bodies

118
Q

Endometrioid type endometrial carcinoma is caused by unopposed estrogen + loss of _

A

Endometrioid type endometrial carcinoma is caused by unopposed estrogen + loss of PTEN/ mismatch repair protein
* Histology will show abnormally arranged endometrial cells

119
Q

Overaggressive dilation and curettage (D&C) can cause loss of the basalis layer leading to secondary amenorrhea called _ syndrome

A

Overaggressive dilation and curettage (D&C) can cause loss of the basalis layer leading to secondary amenorrhea called Asherman syndrome

120
Q

Tamoxifen can cause endometrial polyps due to its _ effects on the endometrium

A

Tamoxifen can cause endometrial polyps due to its pro-estrogenic effects on the endometrium
* Tamoxifen treats breast cancer due to its anti-estrogenic effects on the breast, however, it has pro-estrogenic effects on the endometrium

121
Q

Endometriosis carries an increased risk of carcinoma, especially in _ site

A

Endometriosis carries an increased risk of carcinoma, especially in ovaries
* Ovaries are the most common site of involvement

122
Q

The most important predictor for progression of endometrial hyperplasia to carcinoma is _

A

The most important predictor for progression of endometrial hyperplasia to carcinoma is presence of cellular atypia

123
Q

The most common invasive carcinoma of the female genital tract is _

A

The most common invasive carcinoma of the female genital tract is endometrial carcinoma

124
Q

Endometrial carcinoma arises via two different pathways _ and _

A

Endometrial carcinoma arises via two different pathways hyperplasia and sporatic
* 75% of the time it is the hyperplasia pathway

125
Q

Endometrial hyperplasia –> endometrial carcinoma will normally have _ histology

A

Endometrial hyperplasia –> endometrial carcinoma will normally have endometrioid histology

126
Q

In the sporatic pathway, endometrial carcinoma arises in an atrophic endometrium with no precursor lesions; histology will be _

A

In the sporatic pathway, endometrial carcinoma arises in an atrophic endometrium with no precursor lesions; histology will be serous
* Characterized by papillary structures

127
Q

Serous endometrial carcinoma is often associated with _ mutations

A

Serous endometrial carcinoma is often associated with p53 mutations

128
Q

Increased LH in PCOS induces excess androgen production, resulting in _

A

Increased LH in PCOS induces excess androgen production, resulting in hirsutism

129
Q

The most common type of ovarian tumor is a _

A

The most common type of ovarian tumor is a surface epithelial tumor

130
Q

The two most common type of surface epithelial tumors are _ and _

A

The two most common type of surface epithelial tumors are serous and mucinous
* Can be benign or malignant
* Less common subtypes are endometrioid and brenner

131
Q

_ are surface epithelial ovarian tumors composed of bladder-like epithelium and are usually benign

A

Brenner tumors are surface epithelial ovarian tumors composed of bladder-like epithelium and are usually benign
* Coffee bean nuclei

132
Q

Epithelial ovarian carcinomas tend to be aggressive and spread locally, especially to the _

A

Epithelial ovarian carcinomas tend to be aggressive and spread locally, especially to the peritoneum

133
Q

_ is a germ cell tumor that mimics fetal tissue

A

Teratoma is a germ cell tumor that mimics fetal tissue
* Often benign but can contain immature tissue (neural) or somatic malignancy (squamous cell carcinoma of skin) –> malignant

134
Q

The female equivalent of a seminoma is a _

A

The female equivalent of a seminoma is a dysgerminoma
* Most common malignant germ cell tumor in adolescents

135
Q

_ is a tumor composed of large cells with clear cytoplasm and central nuclei that resemble oocytes

A

Dysgerminoma is a tumor composed of large cells with clear cytoplasm and central nuclei (“fried egg”) that resemble oocytes
* May have increased LDH levels

136
Q

_ is a germ cell tumor that mimics the yolk sac and is most common form in children

A

Endodermal sinus tumor is a germ cell tumor that mimics the yolk sac and is most common form in children

137
Q

Yolk sac tumors will often have elevated _

A

Yolk sac tumors will often have elevated serum AFP

138
Q

Yolk sac tumors classically show glomerulus-like structures called _ on histology

A

Yolk sac tumors classically show glomerulus-like structures called Schiller-Duval bodies on histology

139
Q

_ is a malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts that mimics placental tissue

A

Choriocarcinoma is a malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts that mimics placental tissue
* Vili are absent

140
Q

Choriocarcinomas are often associated with high _ levels

A

Choriocarcinomas are often associated with high beta-hcg levels

141
Q

Name three types of sex cord-stromal tumors that can occur in females:

A

Name three types of sex cord-stromal tumors that can occur in females:
1. Granulosa-theca cell tumor
2. Sertoli-Leydig cell tumor
3. Fibroma

142
Q

Granulosa-theca cell tumors cause high _ levels and will have a presentation consistent with this

A

Granulosa-theca cell tumors cause high estrogen levels and will have a presentation consistent with this
* Prior to puberty- precocious puberty
* Reproductive age- menorrhagia
* Postmenopause- endometrial hyperplasia + AUB

143
Q

Sertoli-Leydig cell tumors in a female may result in _

A

Sertoli-Leydig cell tumors in a female may result in excess androgen, hirsutism, virilization

144
Q

A _ is a benign tumor of fibroblasts

A

A fibroma is a benign tumor of fibroblasts
* Type of sex cord-stromal tumor
* “Bundles of spindle-shaped fibroblasts”

145
Q

Fibromas are associated with _ and _ ; this is called Meigs syndrome

A

Fibromas are associated with pleural effusions and ascites; this is called Meigs syndrome

146
Q

Theca-lutein cysts are associated with _ malignancy

A

Theca-lutein cysts are associated with choriocarcinoma

147
Q

Dysgerminoma tumors markers are _ and _

A

Dysgerminoma tumors markers are hCG and LDH

148
Q

Call-Exner bodies may be seen in _ sex cord stromal tumors

A

Call-Exner bodies may be seen in granulosa cell tumors

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