Ovary Pathoma

Question 1

Polycistic ovarian disease is caused by what?

Answer 1

High LH:FSH. Greater than 2.

Question 2

Explain pathophys of polycistic ovarian disease

Answer 2

High amount of androgen (HIRSUITISM), then in peripheral adipose, it will become estrogen, and that will go to pituitary and block FSH and follicles degenerate to become cystic. INFERTILE b/c no ovulation.

HIGH ESTRONE means risk for endometrial carcinoma

Question 3

What are the 3 types of ovarian tumors? Which is most common?

Answer 3

Surface epithelial (most common)

Germ Cell tumor

Sex cord stromal tumor (theca or granulosa)

Question 4

What two things make it possible to differentiate between cyst adenoma and malignant cystadenocarcionma?

Answer 4

Age: cystadenoma in women 30-40

Smoothness of epithelium. Malignant is usually complicated cysts and shaggy linigning

Question 5

What are borderline cystic epithelium tumors?

Answer 5

Technically malignant, but good prognosis. Traits of cyst adenoma and cystadenocarcionma

Question 6

BRCA1 has a risk of what type of cancer outside of the breast?

Answer 6

Serous carcinoma of ovary and fallopian tube. Often salpingo–oophorectomy along with mastectomy

Question 7

Endometrioid carcinoma can be in ovaries

Answer 7

15% of the time there will be tumor in endometrium as well.

Question 8

What is a tumor in the ovary that has urothelium?

Answer 8

Brenner tumor (BladdER, similar words) Bladder and brannier. Coffee Bean nuclei on H&E (First aid 582)

Question 9

Ovarian sufrace tumors present how?

Answer 9

Late. So poor prognosis with vague abdominal symptoms: fullness, pain, compression. They often spread within the peritoneum

Question 10

What is the serum marker for tracking treatment/recurrence of surface epithelial ovarian cancers?

Answer 10

CA-125! Think CA stands for cystadenoma! Not good for screening

Question 11

Who presents with germ cell tumors?

Answer 11

Women ofrepro age usually. Makes sense. So if 15-30, germ cell tumor

30-40 probably benign cystic

60+ is probably malignant surface epithelial tumor

Question 12

What is the most common type of cystic teratoma?

Answer 12

has neuroectoderm tissue.

Question 13

Is a cystic teratoma benign?

Answer 13

Usually yes (which is good b/c most common type), but can the tumor can have a tumor (squamous cell carcinoma)

Question 14

What is strum ovarii?

Answer 14

Cystic teratoma composed of thyroid tissue and can make hyperthyroid with abdominal mass

Question 15

What germ cell tumor has fried egg cells?

Answer 15

Dysgerminoma. They are BAD b/c dys=bad germ=germ cell oma=mass. Look like eggs b/c thats what ovaries look like

Question 16

What is the marker of dysgerminoma?

Answer 16

HCG, LDH

Question 17

What tumor is most common germ cell tumor in kids?

Answer 17

Endodermal sinus tumor

Question 18

What tumor has schiller-duval bodies (aka glomeruloid like structure)

Answer 18

Endodermal sinus tumor. Yolk sac tumor. Blood vessels are in the center with cells arour it to look like a glomerulus

Question 19

What is the tumor marker for endodermal sinus tumor?

Answer 19

It is a yolk sac tumor, so ALPHA FETO PROTEIN (dick, also in liver carcionma, remember?)

Question 20

What is the tumor that resembles trophoblasts and syncytolotrophoblasts?

Answer 20

Choriocarchima. It is bad b/c these cells are dsigned to invade blood vessels. NO chorionic villi are presents.

Question 21

Is embryonal carcinoma bad?

Answer 21

Yeah. b/c early metastasis b/c primitive cells are made to move

Question 22

Granulosa-theca tumors present how?

Answer 22

Post menopausal bleeding (makes sense) and estrogen production. so breast tenderness

Question 23

What are call-exner bodies?

Answer 23

resemble primordial follicles seen in granulosa cell tumors

Question 24

What happens to women with sertoli, leydig tumors?

Answer 24

They happen in ovary and leydigs make Reinke Crystals (pink crystals). Women have hirsutism or virilization

Question 25

What are Reinke crystals?

Answer 25

Sertoli, leydig tumors. In women. They are pink crystals and think of as RANK (like you smell rank) b/c will cause masculine features from testosterone in women and you will smell bad

Question 26

What is Meigs syndrome?

Answer 26

Triad of ovarian fibroma, ascites and hydrothorax.

Question 27

What is a fibroma of the ovary?

Answer 27

Bundles of spindle shaped fibroblastas that can cause meigs syndrome

Question 28

What is a kruckenburg tumor? Where is it from?

Answer 28

Mucinous tumor from outside of ovary to both ovaries. Usually from GI tumor. Breasts can make them as well.

If bilateral, probably metastatic, can be primary if on one side

Question 29

What does a kruckenburg tumor look like on histo?

Answer 29

Signet ring cells. Nucleus displaced to edge of cell

Question 30

What is pseudomyxoma peritonea?

Answer 30

Pseudomyxoma peritonea (so myxedema is bulge, and it is fake dense mass, but just mucous in peritoneum. Name makes sense)

Jelly belly. The peritoneum as a ton of mucus int. Usually from appendix, can metastasize to ovary. JOE SAW IT IN CLINIC!P