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Reproduction Week 2 > Lecture 21: Gynecologic Pathology 3 > Flashcards

Lecture 21: Gynecologic Pathology 3 Flashcards

1
Q

What are the classification of the ovarian tumors?

A
  1. Surface epithelial
  2. Germ cell
  3. Sex-cord stromal
  4. Metastatic
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2
Q

What are the subtypes of surface epithelial ovarian tumors?

A
  1. Benign
    • serous
    • mucinous
  2. Borderline (low malignant/potential serous)
    • mucinous
  3. Malignant
    • serous
    • mucinous
    • endometrioid
    • clear cell
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3
Q

Where do surface epithelial ovarian tumors arise from?

A

Arise from the surface epithelium of the ovary and from epithelial INCLUSION CYSTS

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4
Q

What are differences between serous and mucionous cytadenomas?

A

Mucin have intracytoplasmic Mucin (like intestinal cells)
Serous don’t have cytoplasmic
inclusions

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5
Q

Why the benign cystadenoma nomenclature?

A

Cysts are included

Adenoma = glandular but benign

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6
Q

How do you get inclusion cysts?

A

Ovulation is violent

After egg is ovulated, the surface epithelium might invaginate to give you inclusion cysts

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7
Q

What does carcinoma look like in contrast with benign?

A

Necrosis and hemorrhage

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8
Q

What ovarian masses are most suspicious for malignancy?

A

There are both solid and cystic
Completely cystic masses are mostly benign (as in the water
Balloon effect)
Completely solid masses can be benign or malignant

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9
Q

What are the characteristics of serous carcinoma?

A
  1. papillae, slit like spaces, solid areas
  2. atypical cells with many mitoses
  3. NECROSIS, hemorrhage
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10
Q

What does ovarian carcinoma mucinous type look like?

A

Glands and solid areas

Atypical MUCINOUS epithelial cells

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11
Q

What are the 4 types of malignant surface epithelial ovarian carcinomas?

A
  1. Serous
  2. Mucinous
  3. Clear cell
  4. Endometrioid
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12
Q

What do borderline tumors look like?

A

All solid, could be either benign or malignant

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13
Q

What are borderline epithelial tumors?

A
  1. clinical and pathologic features in between benign and frankly malignant tumors
  2. much better prognosis than carcinomas
  3. more epithelial proliferation and atypia than in benign tumors
  4. May be associated with extraovarian lesions on
    i. peritoneal surfaces
    ii. omentum
    iii. lymph nodes
  5. NO INVASION
    You cannot tell if something is a borderline tumor until you look underneath the microscope
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14
Q

How do ovarian carcinomas spread?

A 
Spread over
	i. PERITONEAL surfaces
	ii. omentum
No signs or symptoms in early stage
Most patients present with ADVANCED disease
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15
Q

What symptoms of ovarian carcinomas can present?

A
  1. bloating
  2. abdominal pain
  3. urinary
  4. GI symptoms
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16
Q

What is the most common malignant ovarian tumor?

A

Ovarian SEROUS carcinoma

17
Q

Where do ovarian carcinomas arise in women with BRCA1 and BRCA2?

A

High grade serous carcinoma
AND
A significant percentage of these BRCA related tumors arise from the FALLOPIAN TUBE epithelium

18
Q

What genetic signatures indicated low grade serous carcinoma?

A

KRAS

BRAF

19
Q

What genetic signatures indicate high grade serous carcinoma?

A

P53

BRCA1 and BRCA2

20
Q

What is a dermoid cyst?

A

A mature cystic teratoma
Very rare to have transformation
BENIGN

21
Q

How does dermoid cyst present?

A

Greasy as shit with teeth

You can have any type cell within

22
Q

What is a dysgerminoma?

A

Most common malignant germ cell tumor

But only 1% of all ovarian germ cell tumors

23
Q

What is the histological characteristic of ovarian germ cell tumor?

A

Dermoid cyst/cystic teratoma

You can have any type of cells in there!!

24
Q

What are the two types of sex cord stromal tumors?

A
  1. Granulosa cell tumor MALIGNANT

2. Thecoma and/or fibroma tumor BENIGN

25
Q

What are the characteristics of granulosa cell tumor?

A

Mos malignant sex-cord stromal tumor

Malignant potential

26
Q

What is the characteristic of thecoma-fibroma tumor?

A

A type of sex-cord stromal tumor
Secrete estrogen
Most BENIGN

27
Q

What ovarian tumors can produce hormones?

A 
The sex-cord stromal tumors!
Granulosa cell tumor
Thecoma-fibroma tumors 
The secrete estrogen motherfuckerr
Estrogen then causes endometrial hyperplasia/carcinoma
28
Q

What do follicles look like histologically? Granulosa cells?

A

Follicles = call-Exner bodies

Granulosa cells = grooved nuclei = coffee bean

29
Q

What does thecoma look like?

A

Yellow

Lipid droplets

30
Q

What is significant about ovarian fibroma?

A

NO HORMONE PRODUCTION
Associated with two rare syndromes
1. Meigs’ syndrome: ascites and pleural effusion accompanying ovarian fibroma
2. Gorlin’s syndrome: nevoid basal cell carcinoma syndrome (multiple fibromas)

31
Q

What is a Krukenberg tumor?

A

Metastatic ovarian cancer
Comes from pancreas, colon, stomach, cervix
Solid tumor
Bilateral ovarian masses

32
Q

What are the histologic characteristics of krukenburg tumor?

A

Signet rings

Reproduction Week 2 (14 decks)

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