ovarian path

Question 1

Answer 1

Ovarian tumors:

Left= borderline tumor; little trees growing in the cyst

Right= malignant; solid, variably colored tumor

Question 2

Ovarian tumor

Answer 2

papillary serous cystadenoma; finger-like projections lined by single layer of uniform ciliated epithelial cells

mostly benign

Question 3

ovarian tumor

Answer 3

Ovarian mucinous tumor; intestinal type; goblet cells, most common, risk of jelly belly

Question 4

ovarian tumor

Answer 4

Ovarian mullerian mucinous tumor with endocervical-like mucosa; usually no goblet cells, no risk of mets or jelly belly

Question 5

Ovarian tumor

Answer 5

Endometrioid adenocarcinoma; invasive

Question 6

Ovarian tumor

Answer 6

Clear cell carcinoma; looks a lot like yolk sac tumor as well as CCC of kidney

Most often malignant

Question 7

Ovarian tumor

Answer 7

Brenner tumor; resembles renal pelvic tumor (bladder urothelium); almost always benign

Question 8

ovarian tumor

Answer 8

Ovarian teratoma

Question 9

Ovarian tumor

Answer 9

Top L: matura teratoma w/ struma ovarri (thyroid tissue)

Bottom R: immature teratoma; see rosettes on path, can be low grade or high, but has metastatic potential

Question 10

Ovarian tumor

Answer 10

Yolk Sac (Endodermal sinus) tumor; a germ cell tumor characterized by elevated serum AFP (staining + for AFP in magnified view), as well as Schiller Duval bodies; excellent prognosis w/ chemo

Question 11

ovarian tumor

Answer 11

Yolk sac tumor; with Schiller Duval body (papillary structure w/ fibrovascular core, lined by tumor cells with clear cytoplasm and dark malignant-appearing nuclei); looks a lot like a clear cell carcinoma;

See elevated AFP (serum) and in younger pts (how to differeniate from CCC)

Question 12

Ovarian tumor

Answer 12

Dysgerminoma; the female equiv. of a seminoma; on histo see “fried eggs and lymphocytes”

Question 13

ovarian tumor

Answer 13

Granulosa Cell Tumor (adult); see sheets of small tumor cells wiht grooved/coffee-bean nuclei; also see Call-Exner bodies (glandular-like structures with hyalin in middle); usually seen in postmenopausal women with PMB (estrogen producing tumor)

Question 14

ovarian tumor

Answer 14

Granulosa cell tumor; see sheets of uniform tumor celsl with coffee-bean/grooved nuclei; all GCT’s stain positive for Inhibin; usually seen in older women with PMB.

Question 15

Ovarian tumor

Answer 15

Sertoli-Leydig cell tumor; usually occurs in younger women (20-40) with assoc. androgen effects (i.e. virilization)

histo: tubule-like glands lined by sertoli cells that stain for inhibin

Question 16

Ovarian tumor

Answer 16

Stromal tumors: fibroma, leiomya, thecoma==all are benign

Question 17

ovarian tumor

Answer 17

Fibroma, Leiomya=solid white tumor of ovary; bening

Meig’s syndrome is a solid white ovarian mass with pleural effusion, maybe ascites as well as elevated CA-125; looks malignant at first, but once you get histo/cytopath see it’s benign.

Question 18

Answer 18

Primordial Follicle; oocyte surrounded by single layer of granulosa cells; arrested in 1st prophase of meiosis for up to 50 yrs, and recruited to develop after puberty

Question 19

Answer 19

Primary unilaminar follicle; oocyte in prophase I and secretes glycoproteins to made zona pellucida; follicular cells a monolayer of cuboidal cells with FSH receptors

Are gonadotropin-independent, and are stimulated to develop from primordial follicle by paracrine factors

Question 20

Answer 20

Primary multilaminar follicle; oocyte still in prophase I; stratified layer of granulosa cells surround and have FSH receptors; oocyte and granulosa cells connected by gap jxns; stroma cells form theca layer

Question 21

Answer 21

Antral Secondary Follicle; atrum = fluid collection amidst granulosa cells; LH stimulates androgen production by theca cells; FSH stimulates granulosa cells to growth, and synthesize E, Inhibin, IGF-1, and activin.

Cohort of antral follicles will grow (in response to gonadotropins) and 1 will be selected for ovulation as dominant follicle.

Question 22

Answer 22

Mature Graafian Follicle; dominant follicle that continues to grow; oocyte surrounded by GC’s and suspended in fluid = cumulus oophorus

Oocyte still in prophase I but primed to continue meiosis

Big increase in E due to FSH and follicular factors

Vascularization of theca layer

Question 23

Answer 23

Corpus Luteum; remnant of dominant follicle s/p ovulation; LH creates and maintains CL.

GC’s luteinize (fill with fat) and produce Progesterone, E, and Inhibin A

Decrease in FSH halts further follicular development

Question 24

Answer 24

Ovary with fully developed CL; note yellow color of CL due to lipid

Question 25

Answer 25

Corpus albicans; the remnant of a regressing CL (luteolysis)

See drop in P (endometrium shed) and drop in Inhibin (and secondary increase in FSH and follicular development).