ovarian pathology Flashcards
1
Q
decreased estrogen
increased LH
icnreased FSH
A
pattern = primary gonadal
premature ovarian failure
2
Q
define premature ovarian failure
A
premature atresia of ovarian follicles in women of reproductive age
3
Q
signs of menopause in women < 40 but after puberty
A
premature ovarina failure
4
Q
list the most common causes of ovarian failure
A
pregnancy PCOS obesity HPO axis abnormalities premature ovarian failure hyperprolactinemia thyroid disorders eating disorders competitite athletics cushing syndrome adrenal insufficiency
5
Q
what causes PCOS/stein leventhal syndrome
A
hyperinsulinemia and or insulin resistance - thought to alter the hypothalamic hormonal feedback response
6
Q
describe the pathogen of PCOS
A
increased Lh:FSH ratio
icnreased androgens from theca interna cells
decrease rate of follicular maturation - unruptured folicles/cysts and anovulation
7
Q
what is a common cause of subfertility in women
A
PCOS
8
Q
amenorrhea/oligomenorreah hirsuitism acne subfertility obesity acnathosis nigricans
A
PCOS
9
Q
apperance of ovaries in PCOS
A
bilatera
enlarged
cystic
10
Q
what are complications of PCOS
A
increase risk of endometrical cancer due to unopposed estrogem from repeated anovulatory cycles
11
Q
treatment of PCOS please
A
weight reduction OCPs clomiphene citrate ketoconazole spironolactone
12
Q
hormone changes in PCOS
A
LH:FSH> 3 increased testosterone increased androstenedione decreased SHBG FSH normal or decreased
13
Q
increased testosterone icnreased androstenedione decreased SHBG normal to decreased FHS LH>FSH by x3 female
A
PCOS
14
Q
what is the most common ovarina mass in young women
A
follicular cyst
15
Q
what tis a follicular cyst
A
distention of an unruptured graafian follicle.
16
Q
what are follicular cysts associated with
A
hyperestrogenism
endometrial hyperplasia
17
Q
what is a theca lutein cyste
A
often bilateral and multiple
due to gonadotropin stimulation
18
Q
what are theca lutein cysts caused by vrs follicular cysts
A
gonadotropin stimulation vrs hyperestrogenism
19
Q
what are theca lutein cysts associated with
A
choriocarcinoma and hydatidiform moles
20
Q
what is the most comon adnexla mass in women over 55
A
ovarian neoplasm
21
Q
what do ovarian neoplasms arise from
A
surface epithelium, germ cells, sex cord stromal tissue
22
Q
where do the majority of ovarian maligi tumors arise from
A
epithelial
23
Q
what is the most common maligi ovarina tuomor
A
serous sytadenocarcinoma
24
Q
what increases ris of ovarin tumors
A
increased age infertility endometriosis PCOS genetics - BRCA1 and 2 HNPCC strong family history
25
what decreases risk of ovarian tumors
previouspregnancy
history of breastfeeding
OCPs
tubal ligation
26
adnexal mass
abdominal distension
bowel obstruction
pleural effusion
ovarian neoplasms
27
how do you diagnois ovarian neoplasms
surgically
28
what is CA 125 good for
progression of ovarian tumors NOT diagnosis
29
benign tumor that is lined with fallopian tube liek epithelium
serous cystadenoma
30
benign ovarian neoplasm that is commonlyl bilateral
serous cystadenoma
31
most common ovarian neoplasm
serous cystadenoma
32
benign ovarian neoplasm lined by mucus secreting epithelium
like the endocervix
| mucous cystadenoma
33
benign multiloculated and large ovarian tumor
mucous cystadenoma
34
ovarina neoplasm associated wtih PCOS
endometriom
35
what is an endometrioma
endometriosis in the ovary with cyst formation
36
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pelvic pain
dysmenorrhea
dysparenuia
varies with cycle
mass on ultrasound
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endometrioma
37
what is a chocolate cyst
endometrioma filled with dark, reddish-brown blood
38
most common ovarian tumor in 20-30 year old women
mature cystic termatoma/dermoid cyst
39
benign ovarina neoplas with teeth, hair, sebym
mature cystic teratoma/dermoid cyst
| elements fo all three germ layers
40
ovarian enlargement or ovarian torsion
mature cystic teratoma/dermoid cyst
41
hypertyroidism with icnreased radio I 23 in the pelvic region
20-30 year odl owman
mature cystic teratoma/dermoid cyste
42
struam ovarii?
mature cystic teratoma/dermoid cyst that contains functional thyroid tissue
43
benign ovarian tumor that looks like a bladder
brenner tumour
44
solid tumor that is pale yello-tan and appears encapsulated
| benign
brenner tumour
45
coffee bean nuclei on H and E
brenner tumour
46
benign ovarian neoplasm with bunles of spindle spahed fibroblasts
fibromas
47
ovarian neoplas = ?
ascites
hydrothorax on right
fibroma
48
pullign sensation in groin
| beging
fibroma
49
beging that produces estrogen
thecoma
50
abonrmal uterine bleeding in postenopausal woen
thecoma
51
what are the aggressive ovarian tumors?
immature teratoma
| yolk sac/endodermal sinus tumor
52
maligi with fetal neuroectorm
immature teratoma
53
which type of teratoma is more likely to contain thyroid tissue
mature benign
| immature maligi - neuorectoderm
54
what is the most common maliginant stromal ovarina neoplasm
granulosa cell tumor
55
who gets granulos acell tumors
women in their 50s
56
production fo estrogen and progesterone
abnormal uterine bleeding
breast tenderness
granulosa cell
| maligi
57
call exner bodies
granulosa cell
| maligi
58
histopathos of granulosa cell tumor
call exner bodies - granulosa cells arranged haphazardly aroudn collections of eosinophiic fluid
look like primordial follicles
59
maligi tumor bilateral
serous cystadenocarcinoma
60
psammoma bodies ovarioan neoplasm
serous cystadenomcarcnoma
61
pseudomyxoma perionie is what?
intraperitoneal accumulation of mucinous material
62
what causes pseudomyxoma peritonei?
appendiceal tumor > mucinous cystadenocarcinoma
63
what type of maligi ovarian neoplasm is common in adolescents
dysgerminoma
64
LDH high
| hCG
dysgerminoma
65
equivalent of male seminoma
dysgerminoma
only rare
< 1% of all tumors
30% of germ cell tumors
66
histopathos of dysgerminoma
sheets of uniform fried egg cells
67
what ovarina with peutz jegher
sertoli leydig cells
| masculinization
68
ovarina tumor that happens after pregnancy in either the mother or the baby
choriocarcinoma
69
describe histopathos of choriocarcinoma
maligi of trophoblastic tissue (cytotrophoblasts, syncytiotrophoblasts)
no chorionic villi
70
increased bilateral thecal lutein cysts
choriocarcinoma
71
increased bhCG
shortness of breath
hemoptysis
and why please
choriocarcionoma
| hematogenosu spread to lungs
72
what tumor is very responsive to chemotherapy
choriocarcinoma
73
ovaries/testes or sacrococcygeal area in young children
yolk sac/ednodermal sinus tumor
| germ cells
74
what is most common tumor in male infants
yolk sac/endodermal sinus tumor
75
gross of yolk sac/endodermal sinus tumor
yellow
fribale/hemorrhagic
solid mass
76
shiller duval bodies?
yolk sac/endodermal sinus tumor
| look like glomeruli
77
AFP
yolk sac/endodermal sinus tumour
78
average age of incideince 23 yo
| most common tumor of < 4 years old
yolk sac/endodermal sinus tumour
79
bilatera muscin secreting signet cella denocarcinoma
krkenberg from mets from git vi hematogenosu spread
80
list the tumor given marker
a) increased hCG and LDH
b) increased AFP
c) increased b-hCG
d) CA 125
e) LDH
a) increased hCG and LDH - dysgerminoma
b) increased AFP - yolk sac/endodermal sinus tumor
c) increased b-hCG - choriocarcinoma
d) increased Ca-125 - ovarian tumors from surface
e) increased LDH - nonspecific cancer marker
81
germ cell tumors ?
mature cystic teratoma
dysgerminoma
yolk sac tumor
82
tumor associated with turner syndrome
dysgerminoma - fried egg - increased hcg and ldh
83
name the tumor
a) call exner bodies
b) psamomma bodies
c) fried eggs
d) yellow, friable/hemorrhagic and solid
e) schiller duval bodies
f) neuroectoderm
a) call exner - look like primordial follicles - granulosa cell
b) psamomma bodes - concentric calcifications - serous cystadenocarcinoma
c) fried eggs - dysgerminoma
d) yellow/hemorrhagic/solid - yolk sac/endodermal sinus
e) schiller duval - yolk sac/endodermal sinus = glomeruli
f) neuroectoderm - immature teratoma
84
list the sex cord tumors
granulosa cell - call exner bodies\
fibromas - meigs, pulolin sensation
thecomas - estrogen and uterine bleeding
85
list the surface tumours
serous and mucinous and brenner
86
key findings. name the tumor:
a) agressive, neuroectoderm
b) estrogen, abnormal uterine bleeding
c) call exner bodies, estrogen, 50s
d) ovarina mass, ascites, hydrothorax, pulling in groin
e) psamomma bodies, bilateral
f) coffee bean, bladder
g) pale, yellow-tan, solid, encapsulated
h) yellow, friable/hemorrhagic solid
h. 2) AFP increased
i) pseudomyxoma perionie
j) hyperthyroidisim, 20-30s
k) icnreased hCG and LDH, fried eggs
l) pelvic pain, dyspaneuria, dysmenorrhea
m) bilateral multiple theca-lutein cysts
n) multiloculated, large
n. 2) schiller duval bodies
o) increased bHCG, SOB, hemoptysis
p) very responsive to chemotherapy
q) most common
r) bilateral
s) young children in sarcococcygeal
t) muscin secreting malignant cells, bilateral and abdominal pain
tumor with findings
a) agressive neuroectoderm = immature teratoma
b) estrogen, abnormal uterine bleeding = thecoma
c) call exner bodies, estrogen, 50s = granulosa cell
d) ovarina mass, ascites, hydrothorax, pulling in groin = fibroma
e) psamomma bodes, bilateral = serous cystadenocarcinoma
f) coffee bean, bladder - brenner tumour
g) pale, yellow-tan, solid, encapsulated = brenner tumor
h) yellow, friable/hemorrhagic solid = yolk sac/endodermal sinus
h. 2) AFP icnreased = yolk/endodermal sinus
i) pseudomyxoma peritoni = mucous cystadenocarcinoma or appendiceal tumor
j) hyperthyroidism, 20-30s = mature teratoma/dermoid cyst
k) increased hCG and LDH, fried eggs = dysgerminoma
l) pelvic pain, dyspaneuria, dysmenorrheao = endometrioma
m) bilateral multiple theca-lutein cysts = choriocarcinoma
n) multiloculated, large = mucous cystadenoma
o) increased bHCG, SOB, hemoptysis = choriocarcinoma
p) very responseive the chemo = choriocarcinoma
q) most common - serous
r) bilateral - serous
s) young children in sarcococcygeal = yold salk
t) mucin secreting maligi, bilateral and ab pain = krukenberg
87
tumor markers
| increasd hcg and ldh
dysgerminoma
88
increasd afp
yold sac
89
increased bhcg
choriocarcinoma
