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Repro and Sexual Health > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

What can ovarian pathology cause?

A

Pain
Swelling
Endocrine effects

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2
Q

What are the main pathologies that occur with the ovary?

A

Cysts
Endometriosis
Tumours

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3
Q

From what structure can ovarian cysts arise from?

A 
Follicular; pcos
Luteal
Endometriotic 
Epithelial
Mesothelial
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4
Q

When do follicular cysts form?

A

When ovulation doesn’t occur
Follicle doesn’t rupture but grows until it becomes a cyst
Can grow up to several cm in size

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5
Q

What is the structure of a follicular cyst?

A

Thin walled

Lined by granulosa cells

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6
Q

What is endometriosis?

A

Endometrial glands and stroma outside the uterine body

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7
Q

What can endometriosis cause?

A

Pelvic inflammation
Infertility
PAin
Adhesions; increased risk of ectopic pregnancy

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8
Q

What is the pathogenesis of ovarian endometriosis?

A

Regurgitation
Metaplasia
Vascular or lymphatic dissemination

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9
Q

What are the macroscopic appearances of ovarian endometriosis?

A

Peritoneal sports or nodules
Fibrous adhesions
Chocolate cysts

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10
Q

What are the microscopic appearances of ovarian endometriosis?

A

Endometrial glands and stroma
Haemorrhage
Inflammation
Fibrosis

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11
Q

What are known complications of endometriosis?

A 
Pain
Cyst formation 
Adhesions
Infertility 
Ectopic pregnancy; scarring of fallopian tubes
Malignancy
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12
Q

What ovarian malignancy does endometriosis increase the risk of?

A

Endometrioid and clear cell carcinoma

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13
Q

What are the classification subtypes of ovarian tumours?

A 
Epithelial - most common 
Germ cell - young women
Sex cord/ stromal 
Metastatic
Miscellaneous
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14
Q

What are the different forms of epithelial ovarian tumours?

A 
Serous
Mucinous
Endometrioid
Clear cell
Brenner
Undifferentiated carcinoma
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15
Q

How are epithelial ovarian tumours subdivided?

A

Histopathological examination; benign/ borderline/ malignant

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16
Q

What is the commonest form of ovarian cancer?

A

High grade serous carcinoma

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17
Q

What is the histopathological appearance of a benign epithelial ovarian tumour?

A

No cytological abnormalities
Proliferative activity absent or scant
No stromal invasion

18
Q

What is the histopathological appearance of a borderline epithelial ovarian tumour?

A

Cytological abnormalities
Proliferative
No stromal invasion

19
Q

What is the histopathological appearance of a malignant epithelial ovarian tumour?

A

Stromal invasion

20
Q

What is the precursor to high grade serous carcinomas of the ovary?

A

Serous tubal intraepithelial carcinoma (STIC)

Tubal in origin

21
Q

What is the precursor to lo grade serous carcinoma of the ovary?

A

Serous borderline tumour

22
Q

What ovarian tumour type is assoc with BRCA?

A

High grade serous; important in primary prevention to remove ovary and fallopian tube

23
Q

What do endometrioid and clear cell carcinoma of the ovary have a strong assoc with?

A

Endometriosis of the ovary

Lynch syndrome

24
Q

How is the primary diagnosis of ovarian cancer often made?

A

Ascitic tap

25
Q

What makes a mass highly suspicious of a malignancy?

A

Extensive solid growth

Some cystic features

26
Q

What is a brenner tumour?

A

Tumour of transitional type epithelium, usually benign, borderline and malignant warients

27
Q

What structure does transitional epithelium typically line?

A

Bladder

28
Q

What is the commonest germ cell tumour of the ovary?

A

Mature benign cystic teratoma

29
Q

What do dermoid cysts contain?

A

Cystic
Sebum
Hair
Ectoderm, mesoderm and endoderm

30
Q

What is a good diagnostic tip for a dermoid cyst?

A

If any mass on the ovary has fat = dermoid cyst

31
Q

What are other rare germ cell tumours of the ovary aside from dermoid cyst?

A 
Immature teratoma
Dysgerminoma
Yolk sac tumour
Choriocarcinoma
Mixed germ cell tumour
32
Q

What is a dysgerminoma?

A

Most common malignant primitive germ cell tumour

Almost exclusively children and young women

33
Q

What are the 3 types of sex cord/ stromal tumours seen in the ovaries?

A

Fibroma/ thecoma - benign, produces oestrogen causing uterine bleeding
Granulosa cell tumour - potentially malignant. Oestrogenic manifestations
Sertoli-Leydig cell - can produce androgens

34
Q

What is the macroscopic appearance of an ovarian fibroma?

A

White blob

Potato like

35
Q

From what primary site can cancers metastasize to the ovary?

A

Stomach
Colon
Breast
Pancreas

36
Q

When should mets be considered in ovarian tumours?

A

Bilateral

Small

37
Q

What is the FIGO staging of ovarian ca?

A

1A; limited to one ovary
1B; limited to both ovaries
1C; cancer involves ovarian surface/ rupture/ surgical spill/ tumour in washings
2A; extension or implants on uterus/ fallopian tube
2B; extension to other pelvic intraperitoneal
3A; cancer cells in lining of abdomen microscopically
3B; tumours of 2cm or smaller are lining of abdomen
3C; cancer in lymph nodes of >2cm in dimension
4; distant mets

38
Q

What are common pathologies of the fallopian tubes?

A 
Inflammation; salpingitis
Cysts and tumours
Serous tubal intraepithelial carcinoma
Endometriosis
Ectopic
39
Q

What is an ectopic pregnancy?

A

Implantation of a conceptus outside endometrial cavity

Commonest site is ampulla of fallopian tube

40
Q

When should ectopic pregnancy be considered?

A

In any female of reproductive age with amenorrhoea and acute hypotension or an acute abdomen

Repro and Sexual Health (77 decks)

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