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Anatomical Pathology RCPA Part 2 > Ovary > Flashcards

Ovary Flashcards

1
Q

infections

A

actinomyces

schistosoma

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2
Q

follicular lesions

A

cystic follicles (<3cm)

follicular cysts (>3cm)

luteinized follicle cyst of pregnancy

hyperreactio luteinalis

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3
Q

stromal lesions

A

stromal hyperplasia

stromal hyperthecosis (<5mm)

stromal luteoma (5-30mm)

steroid cell tumour (>30mm)

fibromatosis (hyalinized fibrous tissue, normal follicles)

fibroma (more cellular, no follicles)

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4
Q

pregnancy related lesions

A

solitary luteinized cyst of pregnancy

hyperreactio luteinalis (hgh HCG levels, eg twins, hydrops, mole, chorioca)

pregnancy luteoma (bilateral nodules, often incidental at C-section)

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5
Q

pregnancy luteoma DDX

A

corpus luteum of menstruation: not pregnant, solitary

corpus luteum of pregnancy: early pregnancy, solitary

steroid cell tumour: solitary

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6
Q

trabecular/tubular architecture

A

Sertoli cell tumour (rare)

granulosa cell tumour

carcinoid tumour

struma ovarii

endometrioid ca

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7
Q

small undifferentiated cells

A

Sertoli Leydig cell tumour

granulosa cell tumour

endometrial stromal sarcoma

sclerosing stromal tumour (<30, lobular, HPC vessels, SMA and sex-cord marker+)

sex-cord stromal-like variant of endometrioid adenoca

lymphoma/leukaemia

metastates

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8
Q

bland epithelioid cells

A

carcinoid

endometrioid adenoca

Brenner tumour

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9
Q

spindle cell tumours

A

fibroma

spindle cell carcinoid

endometrioid ca (spindled and sex cord stromal variants)

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10
Q

biphasic tumours

A

teratoma

Sertoli Leydig tumour (heterologous elements esp intestinal epithelium)

spindle and sex cord like variants endometrioid ca

carcinosarcoma

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11
Q

YST mimics of epithelial tumours

A

glandular with intestinal epithelium

hepatoid

endometrioid

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12
Q

YST vs juvenile granulosa cell tumour

A

YST: AFP+ inhibin-

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13
Q

features suggesting metastatic (vs primary)

A

bilateral

multinodular

surface implants

tumour emboli in lymphatics

desmoplasia

microscopic pattern unusual for ovary (eg signet ring, single files)

high nuclear grade for architecture

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14
Q

metastatic colorectal ca vs endometrioid ca

A

CRC:

dirty necrosis

more nuclear atypia for architecture

CK20+ CDX2+

EC:

squamous metaplasia

adjacent endometriosis

adenofibromatous areas

CK7+ PAX8+

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15
Q

LG vs HG serous ovarian ca

A

LG: K-ras or B-raf, mild-mod atypia, <12 mit/10HPF, p53 patchy

HG: TP53 or BRCA1/2, mod-marked atypia, >12 mit/10HPF, p53 diffuse + or -

NB both WT1+ and have psammoma bodies

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16
Q

benign mimics of malignancy

A

Arias-Stella in surface glands

decidual reaction in stroma

placental site nodule

signet ring stromal tumour (rare)

17
Q

malignant mimics of benign

A

lobular ca

signet ring ca

endometrial stromal sarcoma

Anatomical Pathology RCPA Part 2 (30 decks)

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