PATH: Ovaries and Fallopian Tubes Flashcards
What is the term for complete or partial rotation of the ovary on its ligamentous supports–often resultin in impedance of its blood supply?
ovarian torsion
The majority of cases of ovarian torsion occur in what group?
women of reproductive age
What is the most likely factor to predispose to ovarian torsion?
ovarian physiologic cyst or neoplasm
Which ovary is more likely to torse?
right
List the most common presenting symptoms of ovarian torsion.
Pelvic Pain!! (dont' forget to put this in differential) adnexal mass N/V Fever (2-20%)- marker of necrosis Abnormal bleeding from vagina (4%)
How do you diagnose ovarian torsion?
ultrasound
can’t definitively diagnose until surgery
How do you treat ovarian torsion?
SURGICAL EMERGENCY
surgery to detorse the ovary and conserve it. If necrotic, do a salpingo-oophorectomy
What are the 5 most common emergency surgeries in women?
ectopic pregnancy corpus luteum rupture with hemorrhage pelvic inflammatory disease appendicitis ovarian torsion
If someone has an “acute abdomen” what is the best way to make a specific diagnosis?
ultrasound (the fastest way)
If someone has a negative pregnancy test, can you rule out an ectopic pregnancy?
NO! may be too low to detech beta-hCG with a dip stick
What is a large, simple cyst with a thin wall and serous fluid content?
serous cystadenoma (benign)
What is the microscopic pathology of serous cystadenoma?
cuboidal to low columnar ciliated epithelium (like fallopian tube)
What are the types of type 1 ovarian epithelial tumors?
low-grade serous
endometrioid
mucinous
What are the types of type 2 ovaian epithelial tumors?
high-grade serous
If you see a psammoma body in the ovary, what should you automatically think of?
papillary serous carcinoma of the ovary
What ovarian tumor is multicystic (like honey-comb) and is usually filled iwth mucous?
mucinous cystadenoma of the ovary
What are the microscopic findings of mucinous cystadenoma of the ovary?
gland spaces lined by tall columnar epithelial cells with apical mucin
What is a tumor made of polyhedral cells with sharp outlines, cleared cytoplasm and prominent central round nuclei resembling fried eggs called?
dysgerminoma
What other types of cells will be present in a dysgerminoma?
lymphocytes
What is a Schiller Duval body? What is it characteristic of?
glomerulus-like structure of blood vessel enveloped by tumor cells; common feature of yolk sac carcinoma
What is a Call-Exner body? What is it characteristic of?
circular arrangement around a sparsely cellular space recapitulating an ovarian follicle; seen in granulosa cell tumors
What is “jelly belly” known as?
pseudomyxoma pertonei
What is pseudomyxoma peritonei due to?
mucin from a mucinous carcinoma of the appendix
