Large Group 3: Adnexal Mass -Parsa

Question 1

What is the minimum size for a diagnosis of a corpus luteal cyst? Follicular cysts?

Answer 1

CL cyst: > 3 cm

• Convoluted yellow lining composed of large, luteinized granulosa cells
• May be hemorrhagic
• not in post-menopausal because associated with ovulation

Follicular cysts: > 2 cm

• Outer layer of theca interna cells (with clear cytoplasm), usually luteinized –> may produce hormones
• Variable inner layer of granulosa cells

Question 2

When do chocolate cysts form?

Answer 2

when endometriosis affects the fallopian tubes and ovaries –> cystic mass filled with blood

Question 3

What is the most common type ovarian tumor? Is this normally unilateral or bilateral?

Answer 3

serous tumor

bilateral

Question 4

What are the serous tumors divided into?

Answer 4

1. benign cystadenomas, simple or papillary (may contain psammomma bodies )
2. borderline
3. malignant

Question 5

If the abdominal cavity is filled with free mucin, what tumor should be suspected? Where does this normally arise?

Answer 5

Pseudomyxoma peritonei

originates from the appendix

Question 6

What cancer is associated with hobnail cells?

Answer 6

clear cell carcinoma

see cystic glandular spaces with atypically located hobnail cells

Question 7

Which tumor has an epithelial component that consists of nests of transitional-type epithelium (like the bladder)?

Answer 7

Brenner tumors

Question 8

What is necessary for staging?

Answer 8

Lymph node biopsy

Question 9

When is a teratoma considered malignant?

Answer 9

if it contains immature germ cells

Question 10

What is a strum ovarii? What clinical symptom can they present with? What markers are they positive for?

Answer 10

A specialized teratoma composed entirely of mature thyroid tissue

can present with hyperthyroidism

markers=thyroglobulin and TTF-1

Question 11

What is an important feature of ovarian dysgerminomas (females) or testicular seminomas (males)? Why?

Answer 11

extremely radiosensitive!

good survival rate

Question 12

What age group is normally associated with Yolk Sac (endodermal sinus) tumors? What is its characteristic histological feature?

Answer 12

younger persons

characteristic histologic feature is a glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space that is also lined by tumor cells (Schiller-Duval body)

Question 13

Which type of tumor can secrete adrogens to cause virilization?

Answer 13

Sertoli-Leydig cell tumor

Question 14

Which tumor is associated with Meigs syndrome?

Answer 14

Fibroma

Meigs=ascites with right sided hydrothorax

Question 15

Which tumor generally produces large amounts of estrogen and can cause a pt to present with bleeding due to endometrial hyperplasia? What is its important histological finding?

Answer 15

granulosa cell tumors

Call-Exner bodies resemble primitive follicles

inhibin +

Question 16

Is a fibrothecoma normally unilateral or bilateral?

Answer 16

unilateral

associated with Meig’s Syndrome

Question 17

What do cortical inclusion cysts of the ovary arise from?

Answer 17

implantation of detached fallopian tube epithelium at sites where ovulation has disrupted the surface of the ovary

Question 18

What histological finding is associated with Krukenberg tumors?

Answer 18

signet ring cells

Question 19

What do granulosa tumors and PCOS have in common?

Answer 19

both hormonally active –> can cause endometrial hyperplasia or post-menopausal bleeding