Ovaries and Fallopian Tubes Flashcards
Graafian follicle releases the egg in response to a surge of what hormone?
LH
Describe the arrangement of cells surrounding the oocyte of a graafian follicle
Oocyte surrounded by granulosa cells (and liquid center), surrounded by a layer of theca cells, surrounded by the ovarian stroma
What structure forms following the release of the oocyte?
The corpus luteum (formed from the remaining wall of the graafian follicle
LH acts on _________ cells to release _____ (hormone)
LH acts on theca cells to release androgens
FSH acts on ___________ cells to release _________ (Hormone)
FSH acts on granulosa cells to convert androgens to estradiol
Which hormone induces the LH Surge?
Estradiol
What is a luteal cyst?
Unruptured graafian follicle or a ruptured follicle that immediately seals
Forms a cyst filled with serous fluid
PCOS is characterized by excess secretion of what hormone?
Androgens
What causes the excess androgen release in PCOS?
Increased secretion of LH
LH:FSH is >2:1
Why is FSH decreased in PCOS?
High androgens –> high estrone (in adipose tissue) –> decreased FSH (which normally stimulates the conversion of androgens to estradiol)
How does low FSH lead to cysts in PCOS?
low levels of FSH leads to follicular degeneration and cyst formation
Women with PCOS are at risk for what cancer? WhY?
Endometrioid endometrial carcinoma - due to presence of high unopposed estrogen
What drug is given to infertile women with PCOS to help rebalance their hormones?
Metformin
The vast majority of all ovarian caEncers arise from which cell type?
Surface epithelial cells
What age group gets ovarian cancer arising from surface epithelium?
20+
WHat age group gets ovarian cancers arising from germ cells?
0-25+ years old
Name three tumors that arise from the stromal cells
Fibromas
Granulosa-Theca cell tumors
Sertoli-Leydig tumors
Choriocarcinomas arise from which cell type?
ovarian germ cells
Endodermal sinus tumors arise from which ovarian cell type?
Germ cells
Dysgermomas arise from which ovarian cell type?
Germ cells
Describe the histology of a benign serous ovarian tumor
Single layer of tall columnar cells
Describe the histology of a benign mucinous ovarian tumor
Mucin producing epithelial cells
Are serous or mucinous malignant tumors more likely to be bilateral?
Malignant serous tumors are more likely to be bilateral.
Malignant mucinous tumors are usually unilateral
What is the name of the concentrically laminated concretions commonly seen in ovarian tumors?
Psammoma bodies
Name three risk factors for cystadenocarcinomas
nulliparity, family hx, germline mutations of tumor suppressor genes
5-10% of ovarian cystadenomas are familial and associated with germline mutations of which genes?
BRCA1, BRCA2
Do mucinous or serous cystadenomas have a better prognosis?
Mucinous
WHat is the tumor marker used to mark recurrence of ovarian cystadenocarcinomas
CA-125
Are brenner tumors benign or malignant?
Usually benign
What is the histology of Brenner tumors?
Nests of transitional-type epithelium, resembling that of the urinary tract
Urothelium!
What is a dysgerminoma?
Germ cell neoplasm that has not undergone any differentiation
What are embryonal carcinomas?
Germ cell tumors that have undergone only primitive differentiation
What two carcinomas arise from germ cells that have differentiated into extraembryonic tissue?
Choriocarcinomas
Endodermal sinus tract carcinoma (Yolk sac carcinomas)
What are teratomas?
Germ cell tumors that have undergone differentiation into embryonic tissue
What is struma ovarii?
Special type of teratoma that has functional thyroid tissue –> can lead to hyperthyroidism
The immature tissue in immature teratomas generally arise from what type of cells?
neural
What is the best way to treat a dysgerminoma?
Radiation
They are VERY radiation sensitive!
What is the main tumor marker for dysgerminomas?
LDH
Are yolk sac tumors benign or malignant?
Malignant
WHat is the characteristic histology seen in yolk-sac tumors?
Schiller-Duval bodies- “glomeruli-like”
What is the tumor marker used in yolk-sac tumors?
AFP
What is the prognosis of choriocarcinoma?
Malignant, metastatic, often fatal
What is the tumor marker for choriocarcinoma?
hCG
What is the characteristic histology of granulosa cell tumors?
Call-exner bodies
What are the hormonal implications of granulosa cell tumors
Excess estrogen
A post-menopausal woman with endometrial hyperplasia and an ovarian mass has….
Granulosa cell tumor
Sertoli-Leydig cell tumors produce which hormone?
androgen
How do sertoli-leydig cell tumors affect young girls?
It blocks female sexual development in children
Describe the Meigs Syndrome associated with Thecoma-fibromas
Right sided pleural effusions
Ascites
Ovarian mass
Which are the most common mets to the ovaries?
Krukenberg tumors- from gastric cancers
Cancer of the fallopian tube can be of what two types?
Serous or endometrioid type
What are the two most common tumors derived of the ovarian epithelial cells?
Serous or Mucinous cysts
-Can be benign (cystadenoma) or malignant (cystadenocarcinoma)
BRCA1 mutations are associated with which type of ovarian cyst?
Serous cystadenoma
cystic, filled with clear fluid, derived from surface epithelial cells
15% of patients with endometrioid carcinoma of the ovary also has what malignancy?
Endometrioid carcinoma of the endometrium
