PATH: Ovaries and Fallopian Tubes

Question 1

What is the term for complete or partial rotation of the ovary on its ligamentous supports–often resultin in impedance of its blood supply?

Answer 1

ovarian torsion

Question 2

The majority of cases of ovarian torsion occur in what group?

Answer 2

women of reproductive age

Question 3

What is the most likely factor to predispose to ovarian torsion?

Answer 3

ovarian physiologic cyst or neoplasm

Question 4

Which ovary is more likely to torse?

Answer 4

right

Question 5

List the most common presenting symptoms of ovarian torsion.

Answer 5

Pelvic Pain!!  (dont' forget to put this in differential)
adnexal mass
N/V
Fever (2-20%)- marker of necrosis
Abnormal bleeding from vagina (4%)

Question 6

How do you diagnose ovarian torsion?

Answer 6

ultrasound

can’t definitively diagnose until surgery

Question 7

How do you treat ovarian torsion?

Answer 7

SURGICAL EMERGENCY

surgery to detorse the ovary and conserve it. If necrotic, do a salpingo-oophorectomy

Question 8

What are the 5 most common emergency surgeries in women?

Answer 8

ectopic pregnancy
corpus luteum rupture with hemorrhage
pelvic inflammatory disease
appendicitis
ovarian torsion

Question 9

If someone has an “acute abdomen” what is the best way to make a specific diagnosis?

Answer 9

ultrasound (the fastest way)

Question 10

If someone has a negative pregnancy test, can you rule out an ectopic pregnancy?

Answer 10

NO! may be too low to detech beta-hCG with a dip stick

Question 11

What is a large, simple cyst with a thin wall and serous fluid content?

Answer 11

serous cystadenoma (benign)

Question 12

What is the microscopic pathology of serous cystadenoma?

Answer 12

cuboidal to low columnar ciliated epithelium (like fallopian tube)

Question 13

What are the types of type 1 ovarian epithelial tumors?

Answer 13

low-grade serous
endometrioid
mucinous

Question 14

What are the types of type 2 ovaian epithelial tumors?

Answer 14

high-grade serous

Question 15

If you see a psammoma body in the ovary, what should you automatically think of?

Answer 15

papillary serous carcinoma of the ovary

Question 16

What ovarian tumor is multicystic (like honey-comb) and is usually filled iwth mucous?

Answer 16

mucinous cystadenoma of the ovary

Question 17

What are the microscopic findings of mucinous cystadenoma of the ovary?

Answer 17

gland spaces lined by tall columnar epithelial cells with apical mucin

Question 18

What is a tumor made of polyhedral cells with sharp outlines, cleared cytoplasm and prominent central round nuclei resembling fried eggs called?

Answer 18

dysgerminoma

Question 19

What other types of cells will be present in a dysgerminoma?

Answer 19

lymphocytes

Question 20

What is a Schiller Duval body? What is it characteristic of?

Answer 20

glomerulus-like structure of blood vessel enveloped by tumor cells; common feature of yolk sac carcinoma

Question 21

What is a Call-Exner body? What is it characteristic of?

Answer 21

circular arrangement around a sparsely cellular space recapitulating an ovarian follicle; seen in granulosa cell tumors

Question 22

What is “jelly belly” known as?

Answer 22

pseudomyxoma pertonei

Question 23

What is pseudomyxoma peritonei due to?

Answer 23

mucin from a mucinous carcinoma of the appendix