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REPRO > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

What may ovarian pathology appear as?

A
  • pain (severe with TORSION - acute)
  • swelling (appear 40 wks pregnant)
  • endocrine effects
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2
Q

Main ovarian pathologies?

A
  • cysts
  • endometriosis
  • tumors
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3
Q

What are the diff. types of ovarian cysts?

A
  • follicular (benign and resolves in few months)
  • luteal (benign)
  • endometriotic (blood filled)
  • epithelial (benign/malign.)
  • mesothelial
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4
Q

What is a red flag when it comes to cysts?

A
  • High solid content

- high CA125 level

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5
Q

Why may a follicular cyst occur?

A
  • when ovulation doesn’t occur (PCOS)

- follicle doesn’t rupture but GROWS until it becomes a cyst (can grow to to several cm)

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6
Q

What may endometriosis cause?

A
  • pelvic inflammation–> SCARRING
  • infertility (d.t adhesions blocking the fallopian tubes)
  • PAIN
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7
Q

Why may endometriosis occur?

A
  • REGURGITATION
  • METAPLASIA (forming endometrial glands; doesn’t explain the stroma)
  • vascular and lymphatic dissemination
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8
Q

How does enodmetriosis present as?

A
  • peritoneal spots/ nodules
  • fibrous ADHESIONS
  • chocolate cysts
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9
Q

How does enodmetriosis present as?

A
  • peritoneal spots/ nodules (very dark red/black)
  • fibrous ADHESIONS
  • chocolate cysts
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10
Q

WHat are complications of endometriosis?

A
  • Pain
  • Cyst formation
  • Adhesions
  • Infertility—-fusion of cilia in the the tubes or the fimbraie (OBSTRUCT. of blastocyst movement)
  • Ectopic pregnancy
  • Malignancy (endometrioid carcinoma)
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11
Q

What are the diff. types of ovarian tumors?

A
  1. Surface epithelial (MOST COMMON)
  2. germ cell
  3. Sex-cord/ stromal
  4. metastatic
    ( Miscellanous)
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12
Q

What is a red flag for the constituency of ovarian tumors?

A
  • cystic and solid is BAD
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13
Q

What are the types of epithelial ovarian tumors?

A 
Serous * (high and low grade) -----can be a SMALL aggressive tumor
Mucinous*
Endometrioid*
Clear cell *
Brenner*
Undifferentiated carcinoma
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14
Q

How may epithelial tumors be classified?

A
  • bening/ malignant/ borderline
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15
Q

How is borderline tumor diff from benign tumors?

A
  • benign: no stromal invasion, no cytological abnormalities, absent proliferative activity
  • borderline: has cytological abnormalities and proliferation, NO stromal invasion
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16
Q

If HIGH or low grade serous CA more common?

A
  • HIGH grade
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17
Q

What is suggested with surgical management of serous ca?

A

REMOVE ovaries and tubes !

18
Q

What is endometroid tumors a.w?

A
  • strongly a.w endometriosis
  • —–most are low grade and EARLY stage
  • —association with LYNCH Syndrome
19
Q

Which epithelial ovarian tumor has a strong a.w endometriosis?

A
  • Endometroid and Clear Cell carcinoma

—- both also a.w Lynch Syndrome

20
Q

Which ovarian CA has GOOD prognosis?

A
  • Endometroid ca of the ovary
21
Q

Primary dx of ovarian tumors is made on _______

A

ASCITIC fluid

22
Q

Which sex-cord tumors produce estrogen?

A

Fibroma tumor

Granulosa Cell tumor

23
Q

Commonest location from where metastatic tumors arise from?

A
  • stomach
  • colon
  • breast
  • pancreas
24
Q

Fallopian tubes pathology?

A
  • inflammation
  • cysts and tumors
  • endometriosis
  • ectopic prgenancy
  • serous tubal intraepithelial ca
25
Q

Danger of an ectopic pregnany?

A

fatal hemorrhage

26
Q

What does the serous tumor arise from…?

A
  • background of tubal intraepithelial neoplasia
27
Q

What is a follicular cyst lined by?

A
  • granulosa cells
28
Q

How to tell a Malignant epithelial ovarian tumor apart from borderline one?

A
  • Stromal invasion is PRESENT in the malignant type
29
Q

What is the precursor lesion of High grade SEROUS carcinoma?

A
  • STIC
  • serous tubal intraepithelial carcinoma
  • —most are TUBAL in origin
30
Q

What is the precursor lesion of the low grade serous carcinoma?

A
  • serous borderline tumor
31
Q

Most endometroid CA are at what stage _____

A

LOW stage and early

32
Q

What gross distinction can be made by the appearance of serous neoplasia (benign and borderline) on slide 19?

A
  • borderline: papillary appearance (not distinct masses; ragged)
33
Q

What is the brenner tumor usually?

A

BENIGN

others are rare

34
Q

Which type of ovarian tumor comprises of 15-20% of ovarian tumors?

A
  • Germ cell tumors ——Dermoid cyst (mature- benign and cystic)
35
Q

Name the diff. types of germ cell tumors.

A
  • mature teratoma
  • immature teratoma
  • yolk sac tumor
  • choriocarcinoma
  • mixed germ cell tumor
36
Q

Who is exclusively affected by dysgerminoma?

A
  • CHILDREN

- young women (~avg age 22)

37
Q

When should metastatic ovarian tumors be considered?

A
  • when ovarian tumors are BILATERAL and small!
38
Q

What are the stages of Figo Staging in ovarian cancer?

A 
1A: limited to ONE ovary 
.
.
1C: involved ovarian surface/ rupture/spill 
.
.
2A: extension to uterus/tube
2B: ext. to other pelvic intraperitoneal
39
Q

At what stage in FIGO does it highlight peritoneal metastasis?

A

3B: peritoneal metastasis BEYOND pelvis (<2cm)
3C: peritoneal metastasis >2cm

40
Q

Define ectopic pregnancy.

A

implantation of conceptus OUTSIDE the endometrial cavity

41
Q

When is ectopic pregnancy considered as a ddx in a female?

A
  • when any female of a reproductive age comes in with amennorhea, acute hypotension or acute abdomen
42
Q

What are the 4 diff. sites of ectopic pregnancy?

A

ovarian
tubal
interstitial
cervical

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