Ovaries path I Flashcards
what are follicular cysts
common
form if no LH surge and cyst does’t rupture to release its egg, continues to grow and forms cyst
usually reabsorb after 2-3 menstrual cycles
what causes a corpus luteum cyst
if opening from released egg seals off the subsequent corpus luteum can grow into a cyst
what can occur with corpus luteum cyst
may hemorrhage or udnergo torsion
what is an endometrioma
chocoloate cysts from repeated menstural cycles
youn women with sudden unilateral low abdominal pain
torision of ovary
what do you have to rule out if suspect torsion of ovary
ectopic pregnancy
what is Tx for torsion of ovary
surgery to unwind ot remove
what is the #1 cause of torsion of ovary
teratoma
risk factors for ovarian torsion
increased length of ovarian ligament/large ovary
What are components of polycystic ovary disease
oligomenorrhea
hyperandrogenism: hisutisms, inc muscle mass, large clitoris, baldness, acne
polycystic ovaries
obesity, acanthosis nigricans, DM, insulin R, premature ASD, high cholesterol
what disease do you rule out for PCOD
thyroid problems, pituitary problems
what is stromal hyperthecosis
overlaps with PCOD
both ovaries enlarged with hormonally active ovarian stroma
most common in postmenopausal women
virilizaiton may be striking
how does ranking of hirsutism work
scale 0-4, 4 being the most hair
if suspect PCOD what are labs to order
Testosterone levels at 8 am
24 hr urine cortisol levels
DXM suppression test
definition of infertility
failure to conceive after 1 year of sex
> 6mo if >35 y.o
what is fecundity
likeliehood of pregnancy over time
25-50% <3 mo
85% in 1 yr
what can cause pale infertility
endocrine, poor sperm
23 y.o female complaining of infertility
labs to order
day 21 P
3 ng/mL= recent ovulation
endometrial Bx
if 23 y.o infertile patient is anovulatory what could be causes of infertility
PCOS: increased androgen, ovarian cysts
PRL levels, TSH, FSH
if 23 y.o infertile patient does have ovulation what could be cause of infertility and what lab do you do.
hysterosalpingogram to see if blocked or patent
blockage could be PID or mechanical
if patent could be endometriosis, uterine masses, lesion… etc
what lab level will determine if 40 y.o F has ovarian failure
if day 3 FHS levels are increased
majoirty of malignant ovarian tumors are what type
serous tumors, surface epithelial
cystadenomas, borderline tumors, adenocarcinomas type I and III
what are the types of surface epithelial tumors of ovaries
serous
mucinous
endometroid
what are the sex cord-stromal tumors of ovaries
granulosa, fibrothecomas and sertoli-leydig tumors
what are the germ cell tumors of ovaries
teratoma, dysgerminoma, endodermal, sinus (yolk sac)
second most common malignant ovarian tumors
endometroid tumors- adenocarcinoma type I and II
when are ovarian cancers discovered
late presentaiton because often asymptomatic
what are the hereditary assocaitions with ovarian cancer
BRCA 1 and 2
lynch II syndrome MSH2
prognosis of ovarian cancer really depends on what
stage
which ovarian cancers are mroe commonly b/l
serous and endometrial
What is used to follow already Dx ovarian cancer
CA-125
what decreases risk of ovarian cancer
tubal ligation, BCP
wehre do most serous ovarian CA arise
distal fallopian tube
what is a serous cystadenoma
benign common
lined by single layer epithlium
what is a serous borderline carcinoma
more cytologic atypia but NO invasion
usually spread to peritoneum
good survival
what is a serous adenocarcinoma
INVASIVE
type I is low grade- slow progression
type II is aggressive high grade and presents late (if mets <10 % survival
histo of serous adenocarcinoma
single cells that line cyst wall and ciliated
fallopian tube also ciliated
what classifies “borderline”
in between category
no evidence of invasion
Tx for borderline carcinomas
remove
what is exophytic serous carcinoma
surface ovary covered by neoplas
what is cystic serous carcinoma
surface of ovary is smooth because neoplasm inside
serous adenocarcinoma can have what unique histo cahracteristic that is pathoneumonic
psammomma bodies
most mucinous tumors are benign or malignant
benign
what utation is assoc with mucinous tumors or ovaries
KRAS
what is pseudomyxoma peritonei
mucinous ascites with metastatic tumor on peritoneal surfaces
what are endometroid tumors type II markers
p53, CDH1, MI
what are the endometroid tumors type I markers
PTEN and KRAS and beta cetenin
mutation assoc with clear cell carcinoma of ovaries
PTEN mutations or loss of heterozygosity PIK3CA mutation
high grade serious carcinomas and high grade endometroid carcinomas are assoc with what mutations
p53
BRCA1
cytological markers for high grade serous carcinoma of ovary
p53
WT1
Pax8
ER+
cytologic markers for low grade serous carcinoma of ovary
WT1 Pax8
cytologic markers for endometroid carcinomas of ovary
ER +
PAX8+
WT negative!
cytologic markers for clear cell carcinoma of ovary
HNF beta+
negative WT!
ER negative!
cytologic markers for mucinous carcinomas of ovary
CK20+
ER negative!
WT negative!
