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Path Exam 3 > Ovaries > Flashcards

Ovaries Flashcards

1
Q

the condition seen in the image is due to ____ during the ___ phase

A

the condition seen in the image is due to increased estrogen during the follicular phase

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2
Q

chocolate cysts of the ovary is caused by ___ (repeated ___) which induces ____

A

chocolate cysts of the ovary is caused by endometriosis (repeated cyclical hemorrhage) which induces fibrosis, adhesions, severe pain

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3
Q

the morphology of chocolate cysts is normal ____ amidst stroma with ____

A

the morphology of chocolate cysts is normal endometrial glands amidst stroma with hemorrhages (hemosiderin-laden macrophages)

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4
Q

chocolate cysts of the ovary may extend along ___ and is associated with ___ (due to __ scars)

A

chocolate cysts of the ovary may extend along pelvic ligaments and is associated with infertility (due to tubal scars)

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5
Q

“normal endometrial glands amidst stroma with hemorrhages (hemosiderin-laden macrophages”

what is a complication of this condition?

A

infertility

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6
Q

in PCOD, ___ levels are high while ___ levels are low

A

in PCOD, LH levels are high while FSH levels are low

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7
Q

describe the pathogenesis of PCOD

A
  • theca cells make androgen → androgen converted to estrogen in adipose tissue (aromatization mediated by aromatase) → increased estrogen → negative feedback on AP → decreased FSH
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8
Q

describe the presentation of PCOD

A
  • virilization
  • hirsutism
  • not ovulating (b/c need LH surge, not a constant elevation as seen in this disease)
    • infertility
  • amenorrhea, oligomenorrhea
    • infertility
  • obesity
    • peripheral insulin resistance → T2D
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9
Q

list the complications of PCOD

A
  • diabetes (due to insulin resistance)
  • infertility
  • increased estrogen → fibrocystic change in breast and endometrial hyperplasia/carcinoma
  • fibroadenoma/leiomyoma grow bigger
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10
Q

describe what is seen in the ovaries of PCOD patients

A
  • ovaries: large, thick capsule, multiple unruptured follicles as cysts lined by granulosa cells and hypertrophied theca interna cells
  • thick, hypertrophied stroma
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11
Q

“patient presents with virilization and hirsutism–not ovulating. what is a complication of this condition?”

A

increased estrogen →​ endometrial hyperplasia

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12
Q

in general, ____ and ____ reduce the risk of ovarian cancer

in general, increased ___ leads to increased risk of ovarian tumors

A

in general, pregnancy and oral contraceptives reduce the risk of ovarian cancer

increased ovulation = increased risk (early menarche, late menopause increase risk)

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13
Q

list the surface epithelial tumors of the ovary (4)

A
  • serous
  • mucinous
  • endometrioid
  • Brenner’s
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14
Q

list the germ cell tumors of the ovary (4)

A
  • choriocarcinoma = placental tissue
  • endometrial sinus = yolk sac
  • dysgerminoma = oocytes
  • teratoma = fetal tissue (mature/immature/specialized)
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15
Q

list the 3 sex cord stromal tumors of the ovary

A
  • granulosa-theca
  • Sertoli-Leydig
  • fibrothecoma
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16
Q

____ are the most common ovarian tumor

A

serous ovarian tumors are the most common ovarian tumor

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17
Q

in the condition seen in the image, low grade tumors have a mutation in ___ while high grade tumors have a mutation in ____

A

in the condition seen in the image, low-grade tumors have a mutation in KRAS, BRAF while high-grade tumors have a mutation in p53, BRCA1/2

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18
Q

the condition seen in the image is lined by ____

A

the condition seen in the image is lined by single layer of tall columnar ciliated cells

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19
Q

describe the histology of the condition seen in the image

A

borderline: multilayering, moderate mitosis, nuclear atypia BUT NO stromal invasion

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20
Q

describe the histology of the condition seen in the image

A

malignant: multilayering, nuclear atypia and stromal INVASION

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21
Q

the histology of the condition seen in the image is similar to the histology of ____

A

the histology of serous ovarian tumors is similar to the histology of fallopian tubes = tall columnar ciliated

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22
Q

the condition seen in the image is (unilateral or bilateral?) and (unilocular or multilocular?)

A

the condition seen in the image is bilateral and unilocular

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23
Q

the condition seen in the image is a ____ cyst with sticky ____ material rich in ____

A

the condition seen in the image is a multiloculated cyst with sticky gelatinous material rich in glycoproteins

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24
Q

the condition seen in the image are lined by ____ which is similar to ____

A

the condition seen in the image are lined by tall columnar non-ciliated with goblet cells (MUCIN) which is similar to endocervix/intestine

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25
Q

describe a complication of the condition seen in the image

A

peritoneal implant (pseudomyxomaperitonei/jelly belly) in borderline & malignant stage → intestinal obstruction

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26
Q

most cases of pseudomyxoma peritonei are ____ and usually arise from the ____ with secondary ___ and ___ spread

A

most cases of pseudomyxoma peritonei are extraovarian and usually arise from the appendix with secondary ovarian and peritoneal spread

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27
Q

mutations in which 4 tumor suppressor genes can lead to endometrioid tumors?

A

PTEN

KRAS

B-catenin

MSI (microsatellite instability)

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28
Q

describe the gross appearance of endometrioid tumors

A

solid and cystic, small, papillae, velvety surface

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29
Q

the histology of the condition seen in the image is like ____ epithelium

A

the histology of the condition seen in the image is like transitional epithelium

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30
Q

describe the histology of the condition seen in the image

A

spindle cells with nests of urothelium

31
Q

a complication of the condition seen in the image is ___ but NOT ____

A

a complication of the condition seen in the image is torsion but NOT rupture

32
Q

____ is a marker to monitor response to ovarian cancer therapy and disease progression

A

CA-125 is a marker to monitor response to ovarian cancer therapy and disease progression

33
Q

the condition seen in the image is derived from ___ cells

A

the condition seen in the image is derived from 2-3 layers of germ cells

teeth & hair = ectoderm

sebaceous glands = mesoderm

34
Q

the condition seen in the image is an incidental finding when ____

A

the condition seen in the image is an incidental finding when a calcified tooth is found on x-ray

35
Q

describe the complications of the condition seen in the image

A

rupture, torsion, infertility, transformation to invasive squamous cell carcinoma

36
Q

a complication of the condition seen in the image is that it can transform into ____

A

a complication of the condition seen in the image is that it can transform into invasive squamous cell carcinoma

37
Q

describe struma ovarii

A
  • origin = germ cell
  • pathogenesis:
    • thyrotoxicosis d/t production of T3/T4
    • suppresses TSH → thyroid atrophy
38
Q

immature teratoma is commonly found in ____ (demographic)

A

immature teratoma is commonly found in 18-year-old women (demographic)

39
Q

___ found in an immature/malignant teratoma is a poor prognostic sign

A

neuroepithelium found in an immature/malignant teratoma is a poor prognostic sign

40
Q

in an immature/malignant teratoma, the absence of ____ carries an excellent chance of cure

A

in an immature/malignant teratoma, the absence of recurrence in the first 2 years carries an excellent chance of cure

41
Q

an endodermal sinus tumor is derived from ____

A

an endodermal sinus tumor is derived from the yolk sac

42
Q

the tumor markers for endodermal sinus tumor are ___ and ____

A

the tumor markers for endodermal sinus tumor are AFP and A1AT

43
Q

____ are found in an endodermal sinus tumor; describe the appearance

A

Schiller-Duval bodies are found in an endodermal sinus tumor

layers of epithelial cells around blood vessels (glomerulus-like)

44
Q

“5 year old with ovarian mass” or young women = which tumor?

A

endodermal sinus tumor (derived from yolk sac)

45
Q

describe the histology of the condition seen in the image

A

fried-egg cells (sheets of monomorphic cells with prominent nucleus/nucleolus & abundant cytoplasm filled with mucin)

46
Q

the male counterpart to the condition seen in the image is ____

A

the male counterpart to the condition seen in the image is seminoma of the testes

47
Q

the condition seen in the image is commonly seen in ___ patients due to ____

A

the condition seen in the image is commonly seen in Turner’s patients due to gonadal dysgenesis

48
Q

the tumor marker for the condition seen in the image is ____

A

the tumor marker for the condition seen in the image is LDH

49
Q

the cell type seen in the condition in the image is found in which 2 other conditions?

A
  • seminoma of the testes
  • medullary carcinoma of the breast
50
Q

“a patient with Turner’s has a histo slide with sheets of cells with dark blue nucleus and lots of cytoplasm; which similar tumor is found in men?”

A

seminoma of the testes

51
Q

“a patient with Turner’s has a histo slide with sheets of cells with dark blue nucleus and lots of cytoplasm; which similar tumor is found in breasts?”

A

medullary carcinoma

52
Q

describe what is seen in choriocarcinoma

A

hemorrhage, necrosis, pleomorphism, giant cells, multi-nucleation

53
Q

in an ovarian choriocarcinoma, ____ and ___ cells are found

A

in an ovarian choriocarcinoma, malignant cytotrophoblasts (mono-nucleated) and syncytiotrophoblasts (multi-nucleated) cells are found

54
Q

“young girl (<18) with amenorrhea and exaggerated morning sickness”

which tumor?

A

ovarian choriocarcinoma

morning sickness = B-hCG

55
Q

a tumor marker for ovarian choriocarcinoma is ____

A

a tumor marker for ovarian choriocarcinoma is B-hCG

56
Q

ovarian choriocarcinoma spreads via ___ NOT ____

A

ovarian choriocarcinoma spreads via blood NOT lymph

57
Q

the tumor marker for the condition seen in the image is _____

A

the tumor marker for the condition seen in the image is tissue inhibin (which inhibits FSH)

58
Q

on histology of the condition seen in the image, ____ bodies are seen which are ____

A

on histology of the condition seen in the image, Call-Exner bodies are seen which are cuboidal granulosa cells arranged around a central lumen

59
Q

describe the presentation of the condition seen in the image before puberty

A

precocious puberty

60
Q

describe the presentation of the condition seen in the image in peri-menopausal women

A

endometrial hyperplasia w/ uterine bleeding

61
Q

“patient presents with tumor in ovary and endometrial thickening”

OR
“10 yr old with early onset of menarche, heavy periods and precocious puberty”

which tumor?

A

granulosa cell tumor

62
Q

describe the histology of the theca component of the condition seen in the image

A

lipid-leydencells

63
Q

describe the histology of the condition seen in the image

A

large polygonal cells & spindle cells forming gland-like structures around an acidophilic core recapitulating immature follicles

64
Q

describe the complications of the condition seen in the image

A
  • metastasis
  • increased estrogen
    • breast cancer
    • fibrocystic change
    • endometrial carcinoma
    • enlargement of leiomyoma/fibroadenoma
65
Q

describe the histology of the condition seen in the image

A

lipid-leyden (thecoma) & spindle-shaped (fibroma) cells

66
Q

the condition seen in the image has an association with ascites + right sided pleural effusion (hydrothorax) which is ____

A

the condition seen in the image has an association with ascites + right sided pleural effusion (hydrothorax) which is Meig’s syndrome

67
Q

the condition seen in the image is also associated with ____

A

the condition seen in the image is also associated with basal cell nevus syndrome

68
Q

“lady has a palpable abdominal mass that caused abdominal ascites and pleural effusion on the right side”

what is a complication of this condition?

A

TORSION

69
Q

____ are seen in a Sertoli-Leydig cell tumor

A

Reinke crystals are seen in a Sertoli-Leydig cell tumor

70
Q

masculinization is seen in Sertoli-Leydig cell tumors due to increased ____

A

masculinization is seen in Sertoli-Leydig cell tumors due to increased androgens (hirsutism, male distribution of hair, hypertrophy of clitoris, voice changes, virilization)

71
Q

list the 3 origins of Krukenberg tumors

A
  • colon cancer
  • diffuse gastric carcinoma
  • invasive lobular carcinoma of the breast
72
Q

all 3 Krukenberg tumors have __ mutations

A

all 3 Krukenberg tumors have E-cadherin mutations

73
Q

describe the histology of Krukenberg tumors

A

signet ring cells with eccentric nuclei and mucin in the cytoplasm

Path Exam 3 (9 decks)

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