Ovarian pathology Flashcards
main groups of ovarian pathology are? (3)
cysts
endometriosis
tumours
ovarian cysts
-can arise from where?
-follicular (e.g. polycystic ovaries) luteal endometriotic epithelial Mesothelial
folicular cysts
- prevalence?
- how do they form?
- histology?
- treatment?
- very common
- form when ovulation doesn’t occur- the follicle doesnt rupture but grows until becomes a cyst
- thin walled, lined by granulosa cells
- usually resolve over a few months
Endometriosis
- definition?
- presentation?
- sites of occurrence?
- complications?
- endometrial glands and stoma outside the uterine body
- may cause: pelvic inflammation, infertility, pain
-Ovary- chocolate cysts pouch of douglas peritoneal surfaces inc uterus cervix, vulva, vagina bladder, bowel etc.
-pain cyst formation adhesions infertility ectopic preg malignancy (endometrioid carcinoma)
Ovarian endometriosis
- pathogenesis
- macroscopic appearance
- microscopic appearance
-regurgitation, metaplasia, Vascular/lymphatic dissemination
-peritoneal spots/nodules
fibrous adhesions
chocolate cysts
-endometrial glands and Stroma
haemorrhage, inflammation, fibrosis
Ovarian tumours
-name the different classifications
-epithelial germ cell sex cord/stromal metastatic Miscellaneous
name the different types of epithelial ovarian tumours? (6)
serous Mucinous endometrioid Clear cell Brenner Undifferentiated carcinoma
they can be either, benign, borderline or malignant
serous carcinoma
-give the 2 types
-they have different precursor lesions
high grade serous carcinoma:
serous tubal intraepithelial carcinoma, tubal origin
Low grade serous carcinoma:
serous borderline tumour
Endometrioid & clear cell carcinoma
-associated with what?
endometriosis of the ovary and lynch syndrome
what is a brenner tumour?
a tumour of transitional type epithelium, usually benign, borderline and malignant variants are rare
germ cell tumour
- name of the most common
- character (malignant? components?)
- other germ cell tumours? (5)
-Teratoma
-Mature, benign and cystic contains sebum & hair ectoderm, mesoderm, endoderm skin, resp epithelium, gut, adipose rarely becomes malignant
-immature teratoma Dysgerminoma (most common malignant germ cell tumour avrg age 22) Yolk sac tumour choriocarcinoma mixed germ cell tumour
sex cord/stromal tumours
-name the 3 main types of these tumours?
-Fibroma/thecoma
benign but may produce oestrogen causing uterine bleeding
-Granulosa cell tumour
all potentially malignant
may have oestrogen manifestations
-sertoli-leydig cell tumours
rare, might produce androgens
Metastatic ovarian tumours
- commonest origins?
- suspect when?
- stomach, colon, breast, pancreas
- small, bilateral tumours
Figo staging of ovarian cancer
-give the catagories
1A: tumour limited to one ovary
1B: tumour limited to both ovaries
1C:cancer involving ovarian surface/rupture/surgical spill/tumour in washings
2A: extension or implants in uterus/fallopian tube
2B: extension to other pelvic organs, intraperitoneal
3A: retroperitoneal lymph node mets or microscopic extra pelvic peritoneal involvement
3B: Macroscopic mets beyond pelvis up to 2cm in dimension
3C: Macroscopic peritoneal mets >2cm in diameter
4: distant mets
fallopian tube pathology:
give the 5 types of fallopian tube pathology
Inflammation- salpingitis due to infection cysts and tumours serous tubal intraepithelial carcinoma endometriosis ectopic pregnancy
