Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RGU Exam 2 > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

Turner’s syndrome

A
  • 45, X
  • Short stature
  • Coarctation of the aorta
  • Streak ovaries
  • Infertility
  • Amenorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ovarian torsion

A
  • Causes enlargement of ovary
  • Can mimic cystic disease and or tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nonneoplastic and functional cysts

A
  • Follicle cysts
  • Luteal cysts
  • Polycystic ovaries
  • Stromal hyperthecosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Follicular cysts

A
  • Cystic follicles are so common to almost by physiologic
  • Originate in unruptured graafian follicels or in follicles that have ruptured and immediately sealed
  • Cysts usually multiple, occasionally larger than 2cm
  • Filled w/ serous fluid
  • Outer thecal cells can be conspicuous, may have large cytoplasm
  • Granulosa cells can be identified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Luteal cysts

A
  • Normally present in ovary
  • Lined by a rim of bright yellow luteal tissue containing luteinized granulosa cells
  • May rupture and cause a peritoneal reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Polycystic ovary disease

A
  • Affects 3-6% of reproductive age women
  • Etiology not completely understood
  • Central pathologic abnormality is numerous follicle cysts
  • Often assoc. w/ oligomenorrhea
  • Ovaries may be twice normal size
  • Multiple subcortical cysts
  • Thickened superficial cortex
  • Hyperplasia of theca interna: increased production of androgens
  • Cysts lined by theca interna cells lead to increased luteinizing hormone
  • Increased estrogen due to conversion of androgens
  • Enzymes involved in androgen biosynthesis are poorly regulated resulting in excessive androgen production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Polycystic ovary disease presentation

A
  • Anovulation
  • Obesity
  • Hirsutism
  • Virulism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stromal hyperthecosis

A
  • Seen in postmenopausal women
  • May blend w/ PCOD in younger women
  • Uniform enlargement of the ovary up to 7cm
  • Tan, white appearance
  • Usually B/L
  • Hypercellular stroma
  • Luteinized stroma cells
  • Clinical effects similar to PCOD but virulization may be more striking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ovarian tumors

A
  • Approx. 80% of tumors are genign mostly occuring in younger women b/w 20-45
  • Malignant tumors more common in older women b/w 40-65
  • Under age 45: 1/15 are malignant
  • Oveer age 50: 1/3 are malignant
  • Estimated risk of developing ovarian cancer if woman has BRCA-1 or 2 is 20-60% by age 70
  • Mutations in p53 found in 50% of ovarian cancers
  • Most ovarian cancers are serous cystadenocarcinomas
  • 30% of ovarian adenocarcinomas express Her2/neu oncogene and carries a poor prognosis
  • OCP use is assoc. w/ a decreased overall incidence of ovarian tumors
  • Most ovarian tumors originate from the surface epithelium
  • Ovulation traumatizes the surface epithelium due to expulsion of oocytes
  • OCP prevent ovulation and decreases injury to surface epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Epithelial cell origin (surface epithelial-stromal cell tumors) ovarian tumor frequency, malignancy, age affected, types

A
  • Overall frequencey: 65-70%
  • Proportion malignant: 90%
  • Age affected: 20+
  • Types:

*serous tumor

*mucinous tumor

*endometrioid tumor

*clear cell tumor

*brenner tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Germ cell origin ovarian tumor frequency, malignancy, age affected, types

A
  • Overall frequency: 15-20%
  • Proportion malignant: 3-5%
  • Age affected: 0-25+
  • Types:

*teratoma

*dysgerminoma

*endodermal sinus tumor

*choriocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sex cord-stroma origin ovarian tumor frequency, malignancy, age affected, types

A
  • Overall frequency: 5-10%
  • Proportion malignant: 2-3%
  • Age affected: all ages
  • Types:

*fibroma

*granulosa-theca cell tumor

*sertoli-Leydig cell tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metastasis to ovaries tumor frequency, malignancy, age affected, types

A
  • Overall frequency: 5%
  • Proportion malignant: 5%
  • Age affected: variable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ovarian neoplasms-surface epithelial tumors types

A
  • Mucinous tumors
  • Serous tumors
  • Brenner tumors
  • Endometriod tumors
  • Clear cell carcinoma

Pneumonic: My Sister Began Experiencing Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Surface epithelial tumors characteristics

A
  • No significant serum screening tools available
  • CA-125 is present in the serum of more than 80% of pts w/ serous and endometrioid carcinomas but can be elevated in any peritoneal irritation
  • Fallopian tube ligation and oral contraceptives are assoc. w/ a significant reduction in relative risk
  • 2/3 of ovarian tumors
  • Divided into benign, borderline, malignant
  • 90% of all maligant ovarian tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surface epithelial tumors- Serous tumors characteristics

A
  • Cystic spaces w/ papillary formations filled w/ clear fluid
  • Have benign, borderline and malignant types

*classification of tumor is important to therapy

  • 25-30% of all ovarian tumors, most in adults
  • Serous adenocarcinomas are the most common malignant ovarian tumor
  • Benign and borderline tumors are most common b/w age 20-45
  • Serous carcinomas occur later in life
  • 30-50% are B/L
  • Tumors may spread to the peritoneum resulting in ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Surface epithelium tumors- Serous tumors risk factors

A
  • Risk factors are hard to define: higher incidence in women w/ low parity
  • Genetic risk factors: mutations in BRCA1 and 2 increase susceptibility to ovarian cancer, especially high grade types
  • Low grade tumors arising fromm borderline tumors have KRAS and BRAF oncogene mutations
  • High grade tumors have a high freq. of mutations in p53
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Surface epithelial tumors- Serous tumors morphology

A
  • Benign tumors: smooth glistening cyst wall w/ no epithelial thickening or w/ small papillary projections, lined by columnar cells w/ cilia
  • Borderline tumors: increased number of papillary projections w/ complex stromal papillae, stratification of the epithelium and mild nuclear atypia w/o destructive infiltrative growth into the stroma
  • Malignant tumors: may be high or low grade, larger amts of solid or papillary masses, irregularity of tumor, nodularity of capsule, marked nuclear atypia, pleomorphism, mitotic figures, multinucleation, may have psammoma bodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Serous tumors survival rates

A
  • 5yr survival rate for borderline tumors confined within the ovarian mass is 100%
  • 5yr survival rate for malignant tumors confined to the ovarian mass is 70%
  • 5yr survival rate for borderline tumors involving the peritoneum is 90%
  • 5yr survival rate for malignant tumors involving the peritoneum is 25%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Surface epithelial tumors- Serous tumors gross appearance

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Serous cystadenoma histology

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Borderline serous tumor histology

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serious borderline tumor gross appearance

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

High grade serous carcinoma histology

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Surface epithelial tumors- Mucinous tumors

A
  • 15-25% of ovarian tumors
  • B/L in 10-20%
  • Usually seen in middle adult life, rare before puberty or after menopause
  • 80% are borderline or benign
  • Grow larger than serous tumors
  • Mostly multiloculated cysts containing mucinous material
  • Pseudomyxoma peritonei: implant on peritoneal structures
  • Have diff. risk factors than mucinous tumors
  • Smoking
  • Can produce large cystic masses
  • Can be multiloculated filled w/ gelatinous fluid rish in glycoproteins
  • Mucinous cystadenomas are lined by tall columnar epithelium w/ apical mucin and absence of cilia
  • Borderline tumors may have cells w/ more papillary growth and nuclear atypia and nuclear stratifiication
  • Cystadenocarcinomas have solid growth patterns w/ obvious nuclear atypia and stratification, need to look for stroma invasion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Surface epithelial tumors- Mucinous tumors survival rate

A
  • 10yr survival for noninvasive cancers is 95% and 90% for invasive
  • Mucinous cancers that have spread beyond the ovary are usually fatal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mucinous cystadenoma gross appearance

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Surface epithelial tumors- Mucinous tumors mutations

A
  • Mutation of KRAS proto-oncogene is often seen in benign, borderline or malignant tumors
29
Q

Pseudomyxoma peritonei

A
  • Extensive mucinous ascites
  • Cystic epithelial implants on the peritoneal surfaces
  • Freq. involvement of the ovaries
  • In most cases the source is extraovarian most likely the appendix
  • Can result in intestinal obstruction and death
30
Q

Pseudomyxoma peritonei gross appearance

31
Q

Surface epithelial tumors- Endometriod tumors

A
  • 5-10% of ovarian tumors
  • Benign endometriod adenofibromas and borderline endometriod tumors are uncommon
  • Endometriod carcinomas account for approx. 20% of all ovarian tumors
  • Large cystic mass w/ solid areas
  • Resemble endometrial adenocarcinoma, 15-30% of cases are also assoc. w/ endometrial carcinoma
  • May be assoc. w/ endometriosis
  • Most are small well differentiated w/ a good prognosis
32
Q

Surface epithelial tumors- Endometriod tumors risk mutations

A
  • PTEN tumor suppressor gene mutation
  • KRAS and beta-catenin oncogenes
  • p53 mutations common in poorly differentiated tumors
33
Q

Surface epithelial tumors- Clear cell carcinoma

A
  • 40-50yr old
  • May occur in assoc. w/ endometriosis or endometriod carcinoma of the ovary and resembles clear cell carcinoma of the endometrium
  • Now thought to be a variant of endometriod adenocarcinoma
  • Cystic or solid appearance
  • Solid tumors the clear cells are arranged in sheets or tubules
  • In cystic cells the neoplastic cells line the spaces
  • Large tumor cells w/ clear cytoplasm w/ a hobnail cytoplasm
  • Tumors tend to be aggressive and often spread beyond ovary
34
Q

Surface epithelial tumors- Clear cell carcinoma survival rate

A
  • 5yr survival rate is 65% in confined to ovaries
35
Q

Cystadenofibroma

A
  • Tumors w/ a pronounced proliferation of fibrous stroma under the columnar lining epithelium
  • Benign tumors
  • Small and multilocular w/ simple papillary processes
  • May have mucinous, serous, endometrioid and transitional epithelium
  • Borderline lesions are uncommon
36
Q

Surface epithelial tumors- Brenner tumor

A
  • 1-2% of all ovarian tumors
  • Classified as adenofibromas in which the epithelial component consists of nests of transitional-type epithelial cells
  • U/L, firm, white solid
  • Solid and cystic nests of cells resembling transitional cells w/ grooved nuclei
  • Mucinous glands may be present
  • Vary in size from small to large lesions
  • Most tumors are benign
  • Borderline and malignant tumors have been reported
37
Q

Surface epithelial tumors- Brenner tumors gross appearance

38
Q

Germ cell tumors

A
  • Teratomas
  • Dysgerminomas
  • Endometrial sinus (yok sac) tumors
  • Ovarian choriocarcinoma

Pneumonic: The Doctor Examined Ovaries

39
Q

Germ cell tumor flow chart

40
Q

Teratomas

A
  • Mature: benign
  • Immature: malignant
  • Monodermal or highly specialized
41
Q

Mature teratomas

A
  • Cystic often referred to as a dermoid cyst
  • Derived from totipotential cells
  • Seen in young women of reproductive years
  • B/L in 10-20%
  • Cyst wall is wrinkled and gray
  • Tissue resembles that seen in an adult
  • Hair, squamous cells
  • Bone, cartilage
  • Thyroid tissue
  • 1% will undergo malignant transformation in one of the elements: squamous cell carcinoma, thyroid cancer, melanoma
42
Q

Teratoma causes

A
  • Arise from ovum after first meiotic division
  • 46XX
43
Q

Monodermal teratomas

A
  • Struma ovarii: comosed of thyroid tissue, often assoc. w/ hyperthyroidism
  • Carcinoid: arise from the intestinal epithelium and may produce carcinoid syndrome
  • Strumal carcinoid: both elements present
44
Q

Struma ovarii histology

45
Q

Strumal ovarii w/ carcinoid histology

46
Q

Immature malignant teratomas

A
  • Tissue resembles tissue seen in embryo not an adult
  • Mostly in prepubertal adolescents and young women
  • Bulky w/ smooth external surface
  • Solid w/ necrosis and hemorrhage
  • Various amts of immature tissue present such as har, bone, cartilage, glands, nerves
  • Prognosis related to grade and stage
47
Q

Immature teratoma histology

48
Q

Dysgerminoma

A
  • Ovarian counterpart to the seminoma of the testes
  • Solidk soft, fleshy yellow white
  • Composed of large vesicular cells w/ a clear cytoplasm
  • Well defined cell borders
  • Lymphocytic infiltrate
  • Centrally located nucleus
  • 2% of ovarian tumors
  • 50% of malignant germ cell tumors
  • Most occur in second and third decade of life
  • Most have no endocrine function
  • Some may have elevated lvls of chorionic gonadotropin

- Express OCT-3, OCT-4, NANOG transcription factors

- Also express the receptor tyrosine kinase KIT

  • Usually U/L
  • All malignant, only 1/3 are aggressive
  • Overall survival is good
49
Q

Dysgerminoma gross appearance

50
Q

Dysgerminoma histology

51
Q

Endometrial sinus tumor

A
  • AKA yolk sac tumor
  • Rare tumor but 2nd most common malignant tumor of germ cell origin
  • Similar to the yolk sac it has high lvls of alpha fetoprotein and alpha one antitrypsin
  • Schiller Duval body: glomerulus like structure w/ a central blood vessel enveloped by germ cells within a space lined by germ cells
  • Intracellular and extracellular droplets some of which stain for alpha fetoprotein
  • Children and young women
  • Presents w/ abdominal pain and rapidly growing pelvic mass
  • Overall an aggressive lesion
52
Q

Yok sac tumor histology

53
Q

Yok sac tumor- alpha fetoprotein stain

54
Q

Choriocarcinoma

A
  • More commonly of placental origin
  • An example of extraembryonic differentiation of malignant germ cells
  • Usually exists in combination with other germ cell tumors
  • Pure choriocarcinomas are rare
  • Very aggressive w/ early metastasis to lungs, liver and bone
  • Soft yellow fleshy and necrotic
55
Q

Sex cord-stromal tumors

A
  • Granulosa cell tumor
  • Fibroma, thecoma and fibrothecomas
  • Sertoli-Leydig cell tumors

Pneumonic: She Felt Grim

56
Q

Granulosa-theca cell tumors

A
  • Varying proportions of granulosa and theca cell differentiation
  • Composed either entirely of granulosa cells or a combination of both
  • Accounts for 5% of ovarian tumors
  • 2/3 occur in postmenopausal women
  • U/L, yellow
  • Vary from small foci to large solid or cystic masses
  • May grow in cords, sheets or strands
  • Call-Exner bodies: small glandlike structures
  • Thecoma component: clusters or sheets of cuboidal or polygonal cells
  • Produce large amts of estrogen: can be assoc. w/ endometrial hyperplasia, endometrial carcinoma and fibrocystic changes in the breast
  • Granulosa cell forms are all potentially malignant
  • Estimates of clinical malignancy varies from 5-25%
  • Inhibin: higher lvls in tissue and serum may serve as useful marker
57
Q

Granulosa-theca cell tumors mutations

A
  • Most have mutations of FOXL2 which encodes a transcription factor
58
Q

Juvenil granulosa cell tumor histology

59
Q

Granulosa cell tumor histology

60
Q

Fibroma-thecoma

A
  • Usually U/L, soid, lobulated hard, gray white
  • Covered by intact serosa
  • Meig’s syndrome: ovarian tumors, hydrothorax and ascites
  • Assoc. w/ basal cell nevus syndrome
  • Thecomas may secrete estrogen
  • Fibromas are essentially nonhormonal

- Fibroma: composed of fibroblasts

  • Thecoma: plump spindle cells w/ lipid droplets
  • Acct for 4% of all ovarian tumors
  • Most tumors are a combo of both types
61
Q

Fibroma gross appearance

62
Q

Thecoma fibroma histology

63
Q

Sertoli-leydig cell tumors

A
  • Recapitulate cells of the testes
  • Usually produce masculinization or defemination
  • Some have estrogenic effects
  • Peak incidence in 2nd and 3rd decade of life but can occur in women of all ages
  • U/L
  • Solid, gray to golden brown
  • Tubules composed of Sertoli or Leydig cells
64
Q

Sertoli Leydig cell tumor histology

65
Q

Sex cord tumor with annular tubules

A
  • Assoc. in 1/3 of cases w/ Peutz-Jeghers syndrome
  • Has features similar to granulosa cell tumors and a growth pattern similar to Sertoli cells
  • Complex annular tubules containing eosinophilic hyaline bodies
  • May be benign or malignant
66
Q

Sex cord tumor with annular tubules histology

67
Q

Metastatic tumors

A
  • Common primary sites are ovary, uterus, fallopian tubes
  • May have spread from GI tract
  • Krukenburg tumor: metastasis from adenocarcinoma w/ characteristic signet ring cells
68
Q

Krukenburg tumor gross appearance

69
Q

Krukenburg tumor histology

RGU Exam 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions