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Reproduction & Sexual Health > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

Name five types of ovarian cyst

A 
Follicular 
Luteal 
Endometriotic 
Epithelial 
Mesothelial
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2
Q

Describe a follicular cyst

A

Very common, can occur when ovulation does not e.g PCOS

Follicle doesn’t rupture and instead becomes a cyst with thin wall of granulosa cells

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3
Q

What is endometriosis?

A

Endometrial glands/stroma outside of the uterine body

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4
Q

What symptoms can endometriosis cause?

A

Painful heavy periods
Infertility
Pelvic inflammation

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5
Q

Name the common sites of endometriosis

A 
Ovary - chocolate cyst 
Pouch of Douglas 
Peritoneal Surfaces 
Cervix, vulva, vagina
Bladder, bowel
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6
Q

What is thought to be the pathogenesis behind endometriosis?

A
  • regurgitation of endometrium through uterine tubes
  • metaplastic transformation of epithelium
  • vascular/lymphatic dissemination of tissue
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7
Q

Describe the macroscopic appearance of endometriosis

A

Peritoneal spots/nodules, fibrous adhesions due to inflammation

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8
Q

Describe the microscopic appearance of endometriosis

A

Endometrial gland and stoma with surrounding haemorrhage, inflammation and fibrosis

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9
Q

State the complications that can occur due to endometriosis

A

Pain, cyst formation (obstruction of surrounding tissue - ovary), adhesions, infertility (tubal inflammation and scarring), increased risk of ectopic pregnancy and malignancy

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10
Q

What cancers does endometriosis increase your risk of?

A

Endometrioid carcinoma

Clear cell carcinoma

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11
Q

How are ovarian tumours graded?

A

Benign
Borderline
Malignant

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12
Q

What type of cell do ovarian tumours arise from?

A

Mesothelium

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13
Q

Describe benign ovarian tumours

A

No cytological abnormality, proliferative activity absent and no stromal invasion

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14
Q

Describe borderline ovarian tumours

A

Cytological abnormality, increased proliferative activity and risk of progression but no stromal invasion

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15
Q

Describe malignant ovarian tumours

A

Clear evidence of stromal invasion

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16
Q

Where do serous carcinomas arise from?

A

Fallopian tube

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17
Q

What is the precursor to high grade serous carcinoma?

A

Serous tubal intraepithelial carcinoma (STIC)

18
Q

What causes high grade serous carcinomas?

A

p53 mutation

19
Q

What is the precursor to low grade serous carcinoma?

A

Serous borderline tumour

20
Q

Name two risk factors for endometrioid and clear cell ovarian carcinoma

A

Endometriosis

Lynch syndrome

21
Q

What pathological factors suggest malignancy?

A

Cystic spaces, predominantly solid yellow/tan coloured tumour with friable edges and peritoneal deposits

22
Q

Is a brenner tumour benign or malignant?

A

Benign

23
Q

What does a brenner tumour look like?

A

Transitional type epithelium, nests of cells in a fibrous stroma

24
Q

What is the commonest germ cell tumour?

A

Mature cystic teratoma - dermoid cyst

25
Q

What is characteristic of a dermoid cyst?

A

Pleuripotent potential - sebum, hair, cartilage, bone, teeth

26
Q

What rare malignancy can arise from a dermoid cyst?

A

Somatic malignancy - SCC, thyroid cancer

27
Q

What is an immature teratoma?

A

Immature foetal elements present in a tumour

28
Q

Are germ cells usually benign or malignant?

A

Benign

29
Q

What are the malignant germ cell tumours?

A

Dysgerminoma

Choriocarcinoma

30
Q

Describe a dysgerminoma

A

Seminoma equivalent

Most common malignant germ cell tumour, lots of lymphocytes surrounding an abnormal cell

31
Q

Who most commonly has dysgerminoma?

A

Children and young women

32
Q

Name three sex cord/stromal tumours

A

Fibroma/thecoma
Granulosa cell
Sertoli-Leydig

33
Q

Describe a fibroma/thecoma

A

Arises from cells in the ovarian stroma (fibroblast/theca cells). Solid tumour, collagenous (potato like), produces oestrogen

34
Q

Describe granulosa cell tumours

A

Line the follicles which make up the corpus luteum and produce hormones - not often aggressive but all potentially malignant

35
Q

What do sertoli-leydig tumours do?

A

Produce androgens

36
Q

What tumours commonly metastasise to the ovary?

A

Stomach
Colon
Breast
Pancreas

37
Q

Describe the figo staging

A

IA - limited to one ovary
IB - both ovaries
IC - involves ovarian surface/rupture/surgical spill
2A - extension on uterus/fallopian tube
2B - extension to pelvic intraperitoneal
3A - microscopic mets, retroperitoneal lymph nodes
3B - macroscopic mets <2cm
3C - macroscopic mets >2cm
4 - distant mets

38
Q

What pathology can occur in the fallopian tubes?

A 
Inflammation - salpingitis
Cysts and tumours 
Serous tubal intraepithelial carcinoma 
Endometriosis 
Ectopic pregnancy
39
Q

What is hydrosalpinx?

A

Dilatation and fluid filled tubes

40
Q

How are epithelial tumours treated?

A

Surgery - debunk aim for <1-2cm
Chemo
Fertility preservation

41
Q

Name two types of chemotherapy

A

Adjuvant

Neoadjuvant

42
Q

How are non-epithelial tumours treated?

A

Surgery and chemotherapy

Reproduction & Sexual Health (36 decks)

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