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Repro II > ovarian pathology > Flashcards

ovarian pathology Flashcards

1
Q

non-neoplastic cysts

A

follicular cysts
corpus luteum cyst
endometriosis

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2
Q

follicular cysts

A 
very common reach up to 5cm
forms when there is no LH surge and cyst doesn't rupture to release egg
usually harmless
resorb in 2-3 cycles
smooth walled unicameral/simple cysts
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3
Q

corpus luteum cyst

A

if the opening from the released egg seals -> cyst
may spontaneously resolve or grow to 4cm
may hemorrhage or undergo torsion

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4
Q

endometriosis

A

repeated cycles may form chocolate cyst

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5
Q

ovarian torsion

A

sudden unilateral pain
occurs in young adult women typically with mass >5cm
must R/O ectopic by ultrasound
surgery

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6
Q

PCOD

A

aka stein-leventhal syndrome
most common endocrine issue in repro age women
8-10% of all women worldwide

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7
Q

PCOD symptoms

A

oligomenorrhea
hyperandrogenism (hirsutism etc)
polycystic ovareis
obesity, acanthrosis nigricans, DM, premature atherosclerosis

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8
Q

features of PCOD

A 
anovulation
MMR (amenorrhea)
infertility
acne, hirsuitism
insulin resistance and obesity 
high cholesterol
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9
Q

stromal hyperthecosis

A

overlaps with PCOD
usually both ovaries enlarged with hormonally active ovarian stroma
most common in postmenopausal
virulization may be striking

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10
Q

infertility

A

failure to conceive after 1 year of sex

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11
Q

fecundity

A

likelihood of pregnancy over time

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12
Q

serous tumors

A

47%
cystadenoma
borderline tumors
adenocarcinomas (type I and II)

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13
Q

mucinous tumors

A

3%
cystadenoma
adenocarcinoma (only type I)

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14
Q

endometrioid tumors

A

20%

adenocarcinomas (type I and II)

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15
Q

sex-cord stromal tumors

A

granulosa tumors
fibrothecomas
sertoli-leydig tumors

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16
Q

germ cell tumors

A

teratoma
dysgerminoma
endodermal
sinus (yolk sac)

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17
Q

metastatic tumors

A

5%

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18
Q

ovarian CA overview

A 
asymptomatic until late
disease of older women (60s)
BRCA 1&2 mutations
lynch syndrome II (MSH 2 mutation)
prognosis dependent on stage
often b/l
NO effective screening
may arise from distal fallopian tube
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19
Q

serous cystadenoma

A

common benign lined by single layer of epi which is ciliated

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20
Q

serous borderline carcinoma

A

excrescences on cyst wall, more cytologic atypia, NO invasion
papillary
often seed peritonium
100% 5 yr survival

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21
Q

serous adenocarcinoma type I

A

low grade slow progression

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22
Q

serous adenocarcinoma type II

A

presents late

worse prognosis

23
Q

psammoma bodies

A

pathogmonic for serous adenocarcinoma (not specific for either type)

24
Q

mucinous tumors

A

least likely to be b/l (if it is R/O mets)
80% benign
KRAS mutation

25
Q

rupture of mucinous tumors

A

pseudomyxoma peritonei -mucinous ascites w/mets on peritoneal surfaces
usually d/t appendix rupture

26
Q

endometrioid tumros

A

mostly carcinomas
may arise in endometriosis
30% concurrent ovarian and endometrial endometrioid carcinomas

27
Q

type I endometrioid tumors

A

PTEN and KRAS

28
Q

type II endometrioid tumors

A

p53
CDH1
MI

29
Q

high-grade serous immunoprofile

A 
p53+
WT1+
Pax8+
High Ki67
2/3s are ER+
30
Q

high-grade serous mutation

A

tp53

BRCA1,2

31
Q

low-grade serous immunoprofile

A

WT1+
Pax8+
p53-
low Ki67

32
Q

low-grade serous mutations

A

BRAF

KRAS

33
Q

endometrioid carcinoma immunoprofile

A 
ER+
Pax8+
Vimentin+
WT1-
p53-
34
Q

clear cell immunoprofile

A

HNF beta+
WT1-
ER-

35
Q

clear cell mutations

A

KRAS
PTEN
PIK3CA

36
Q

mucinous immunoprofile

A 
CK20+
cdx+
CK7+
ER-
WT1-
37
Q

mucinous mutations

A

KRAS

38
Q

peritoneal carcinomatosis

A

distinctive diffuse seeding of peritoneum
small shallow implants
cytology of ascites can aid Dx

39
Q

what can be used to follow course of surface epi tumors?

A

CA-125

40
Q

High albumin gradient

A 
cirrhoiss
alcoholic hepatitis
heart failure/constrictive pericarditis
massive hepatic mets
budd-chiari syndrome
portal v thrombosis
idiopathic portal fibrosis
41
Q

low albumin graident

A 
peritoneal carcinomatosis
peritoneal TB
pancreatits
serositis
nephrotic syndrome
42
Q

granulosa-thecal cell tumors

A 
any age
2/3 in postmenopausal eomen
hormonally active 75% produce E
yellow 
inhibin +
FOXL2 mutation
callexner bodies
can cause vaginal bleeding
43
Q

fibromas

A 
very common 
solid white hard fibrous tumor
usually u/l
bening
associated with meig syndrome
44
Q

meig syndrome

A

ascites
pleural effusion
ovarian fibroma
resolves with resection of fibroma

45
Q

sertoli-leydig cell tumors

A

rare
all ages
50% produce androgens

46
Q

germ cell tumors

A 
teratomas
dysgerinomas
endodermal sinus (yolk sac)
choriocarcinomas
tend to be benign in adutls and malignant inkids
47
Q

dermoids

A

benign cystic teratoma
2-3 germ cell lines
distinctive rokitanski nodule
1% develop CA (usually SCC)

48
Q

immature malignant tertatoma

A

girls and adolescents
contain immature tissues (embryonal and fetal)
rapid growth and spread

49
Q

monodermal (specialized teratomas)

A

single tissue predominates
carcinoids or struma ovarii most common
functional -> hyperthyrodism and carcinoid syndrome

50
Q

dysgerminoma

A 
ALL MALIGNANT
ovarian counterpart to seminoma
highly sensitive to radiation
only 1/3 aggressive
fried egg appearance on histo
51
Q

endodermal sinus tumor

A 
yolk sac
very aggressive
produces alpha fetoprotein and alpha 1 antitrypsin 
schiller-duval bodies
kids/young adults
chemo
52
Q

choriocarcinoma

A 
usually w/in another germ cell tumor
psudoplacental tissue
aggressive
produce beta-HCG high levels
no sensitive to methotrexate
53
Q

krukenburg tumor

A

b/l mets of mucin producing signet CA cells, especially gastric origin

Repro II (20 decks)

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