Pathology of Fallopian Tubes Flashcards by Iseoluwa Ojo

Inflammations of the fallopian tubes

__________ inflammations
• ________ (60%)
• __________ organism

____________ _____________

Others
• Parasites Schistosomiasis, Enterobiosis
• Fungi Actinomycosis

Suppurative

Gonococci ;Pyogenic

Tuberculous Salpingitis

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Ectopic pregnancy is a consequence of (normal or abnormal?) __________ of the _________ ovum (inside or outside?) of the _______.

abnormal implantation

fertilized ovum ; outside

uterus.

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Ectopic pregnancy

Occurs in ____% of all pregnancies,
• 95% occurs in the ________________,

• Other sites include: the _______, the pelvic _____, and, rarely, the _______ of the __________ ————.

1% ; fallopian tubes,

the ovary

the pelvic peritoneum

surface of the abdominal organs.

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Ectopic pregnancy

If diagnosed in time, the pregnancy can be removed from the __________________ ___________________ally.

• If this is not feasible, the fallopian tube must be ____________ with the ________ and the _________.

distended fallopian tube

laparoscopic

resected together

embryo; placenta

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Tumors and cysts of the fallopian tubes
cysts
– Examples are ___________,_____________

• Tumour-like lesions
–_____________

• Tumours
– Benign- _____________ tumours
– Malignant- ______________ associated with ___________ mutations

hydatids of Morgani; Paratubal cysts

Endometriosis

Adenomatoid ; Adenocarcinoma

BRCA 1 mutations

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Most cysts of the fallopian tube are of no clinical significance

T/F

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Ovarian cysts

Ovarian cysts are ________-filled cavities lined by ___________ .

• Ovarian cysts are usually (small or large?) , _________ , and cause _________ problems.

fluid ; epithelium.

small; solitary

no clinical problems.

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Ovarian cysts

• Majority are ______ cysts.

• Others
– cystic ___________ or
– inclusions of the ________________.

follicular

corpora lutea

surface epithelium

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Polycystic ovary syndrome, also known as ________-_______ syndrome, is a hormonal disturbance of the ____________________________________ axis.

Stein- Leventhal syndrome

hypothalamic-pituitary-ovarian-adrenal axis.

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Polycystic ovary syndrome

Previously, it was thought that the ________ of the ____________________ was the cause of anovulation, but it is now known that the basic problem in such cases is ________.

fibrosis

superficial cortex

hormonal.

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Clinical features of polycystic ovary syndrome

Menstrual ________, (_________ and ____________)

Persistent _________ in 40% of cases

_________

Signs of _______, such as ________.

_______ is a major problem.

irregularities; oligomenorrhea and amenorrhea

anovulation; obesity

virilization; hirsutism

Infertility

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Poly cystic ovaries

The ovaries of these women contain numerous ————- and show _________________.

follicular cysts

superficial fibrosis

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Ovarian tumours

________ tumours are more common.

Benign

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Ovarian tumors

In women younger than ____ years old, only 1 in ______ tumours is malignant.

However, in women older than _____ years, 1 in ____ tumours is malignant.

45; 15

50; 3

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Ovarian tumours- classification

Tumours of _____________
____________ tumors
_____________________tumors
______ tumours

surface epithelium

Germ cell

Sex cord stromal

Benign

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Types Serous tumours

They are typically _______ and filled with ______ serous fluid.

Histologically, they can be _______ , serous ________, _________, or malignant (serous _______________________).

cystic ; clear

benign, serous cystadenomas

borderline ;serous cystadenocarcinomas

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Types Serous tumours

These tumours can also be solid

T/F

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Serous tumors

Approximately ____% of benign and _____% of malignant serous tumors are bilateral.

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Risk factors to Serous tumors

(Poorly or Well?) defined.

Identified only in a minority of cases
• Include ovarian ________,
• _______ cancer syndrome, and
•_____ and _______ gene mutations linked with an increased incidence of _____ cancer.

Poorly

dysgenesis; Familial

BRCA1 and BRCA2

breast

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Serous tumor classification

List them

Low- and high -grade serous carcinoma

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Serous tumor classification

The low-grade tumors
• have mutations in the ______ or _______ oncogenes, with only rare mutations in ________

KRAS or BRAF

p53.

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Serous tumor classification

High Grade tumors
• have high frequency of mutations in the ______ gene but lack mutations in either ________ or ________

p53 ; KRAS or BRAF.

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Most BRCA1 or BRCA2 mutations are _____-grade serous carcinoma and commonly have _____ mutations.

high

p53

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Mucinous tumours

Primary Mucinous tumours rare usually _____lateral.

uni

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Primary Mucinous tumours Associated with ______ mutations • _______ mucinous _____\\ (58%), • Mucinous _______ tumors (75% to 86%) • ___________ mucinous carcinomas (85%)

KRAS Benign mucinous cystadenomas Mucinous borderline tumors Primary ovarian mucinous carcinomas

Endometrioid Carcinoma • (Common or Rare?) • Arise from ————— • May coexist with ______________________

Rare endometriosis; endometrial carcinoma

Endometrioid Carcinoma • Express mutations in _______ tumor suppressor gene, _______ and _________ oncogenes, and __________ _________ similar to endometrial carcinoma

PTEN KRAS β-catenin microsatellite instability

Germ cell tumors •________ • _____________ • _________ carcinoma • ________ tumor

Teratoma • Dysgerminoma • Embryonal carcinoma • Yolk sac

Germ cell tumors Teratoma – _________ – _________ – _________ or _________ teratoma

Mature – Immature – Monodermal or specialized

Germ cell tumors • Dysgerminoma: (_________ in _______) • Embryonal carcinoma: (More or Less?) malignant than dysgerminoma but still may respond to chemotherapy • Yolk sac (________ _______ tumour): (Benign or Malignant?) tumour that secretes ____________

seminoma ; testis More malignant endodermal sinus tumour Malignant; alpha- fetoprotein

The most common Germ cell tumor is ???

Teratoma

Monodermal Teratoma _____lateral ± ______ in the (ipsilateral or contralateral?) ovary

Unilateral ± teratoma contralateral

Monodermal Teratoma Struma Ovarii – • may cause ____________

hyperthyroidism

Monodermal Teratoma Struma Carcinoid- • Thought to arise from the ———- epithelium of the teratoma • May produce _________ resulting in carcinoid tumour • Less than ____% metastasize.

intestinal 5-hydroxytryptamine 2%.

Monodermal Teratoma Struma _______ Struma __________\

Struma Ovarii Struma Carcinoid

Immature teratoma • The component tissues resemble _________ and __________ tissue. • Occurs in __________ adolescents and (young or old?) women • Predominantly (solid or cystic?) • Grading based on the ________________________

embryonal and immature fetal prepubertal adolescents ; young solid; presence of neuroepithelium

Dysgerminoma Ovarian counterpart of the _____________ About ______ of malignant germ cell tumors. 75% occur in the ___________ decades. Rarely there is elevated levels of ———. Majority have ____ endocrine function. Associated with gonadal ________ and ____________ Express receptor tyrosine kinase c-KIT.

seminoma of the testis. half ; 2nd and 3rd HCG.; no __________ dysgenesis ; pseudohermaphroditism

Yolk sac tumour • (Common or Rare?) • it is the _____ most common malignant germ cell tumour • _____lateral and (Slowly or rapidly?) growing • Rich in __________ and _________

Rare; 2nd Uni; rapidly α-fetoprotein and α1-antitrypsin

Yolk sac tumour • Histology – ___________ body – Conspicuous intracellular and extracellular ________ positive for __________ • (Good or Bad?) response to therapy

Schiller-Duval hyaline droplets α-fetoprotein Good

Choriocarcinoma (Common or Rare?) , highly (benign or malignant?) tumor that secretes _________ Usually diagnosed in _________ (boys or girls?) Associated with other germ cell tumours

Rare ; malignant secretes human chorionic gonadotropin (HCG) prepubertal ; girls Associated with other germ cell tumours

Choriocarcinoma Associated with other germ cell tumours Equivalent to __________ choriocarcinoma originating from the _______ in the ______ (Poor or Good?) response to chemotherapy unlike that following ________

gestational choriocarcinoma placenta; uterus Poor ; gestation

Fibroma: This (benign or malignant?) (functioning or non-functioning?) tumour is composed of ________.

benign ; non-functioning fibroblasts.

Fibroma May be associated with ______-sided _________ and ______, (______' syndrome). It is (solid or cystic?) and _____ color on cross section and very (loose or firm?) due to the abundance of _________ in its stroma.

right-sided ; pleural effusion ascites ; Meigs solid ; white firm ; collagen

Most common sex cord tumour is??

Fibroma

Thecoma Similar to ________. It is (benign or malignant?) , (solid or cystic?) , and (loose or firm?) , but on cross section it appears _______.

fibroma benign; solid firm ; yellow.

Thecoma It is composed of ______-shaped cells (_____ cells) that contain ____ and synthesize _______.

spindle theca ; fat oestrogens.

Granulosa cell tumour: _______ and ______ type Composed of _______ cells that may secrete _______. (Solid or Cystic?) and _____color on cross section and usually not as (loose or firm?) as fibromas and thecomas.

Juvenile and adult type granulosa cells; oestrogens. Solid ; yellow firm

Granulosa cell tumour: Histologically, it is composed of ________ cells that may form _______ bodies, like the normal ______ cells in ovarian _______.

granulosa cells Call-Exner bodies granulosa cells ; follicles.

Granulosa cell tumour: (Easy or Difficult?) to predict biologic behavior from histology

Difficult

Sertoli-Leydig cell tumour: – This __________ tumour contains cells resembling testicular _______ and _____ cells. – Secrete _______ and cause ________

biphasic Sertoli and Leydig cells. androgens; virilization

virilization •________ of the voice, _____ and _____ hirsutism •______, _____megaly •__________, _______

deepening ; facial and chest acne ; clitoromegaly amenorrhea; infertility

Hilar cell tumors: Usually (small or large?) ______color nodules in the _____ or the _______. • May secrete _____________

small ; yellow hilus ; ovary. androgens

Metastatic tumours From the uterus, fallopian tube, contralateral ovary, or pelvic peritoneum. Extra-müllerian tumors metastatic to the ovary are carcinomas of the ______ and ________, including colon, stomach, biliary tract, and pancreas. Pseudomyxoma peritonei, derived from _________ tumors. Krukenberg tumor, characterized by _____________ commonest from ______

breast and gastrointestinal tract, appendiceal bilateral metastases Stomach

Hormones associated with ovarian tumours List 6

Glycoprotein CA-125 Oestrogen Androgens Alpha-fetoprotein Human chorionic gonadotropin

Hormones associated with ovarian tumours Glycoprotein CA-125: Found in —- tumors Oestrogens: _______ and _______ tumors Androgens: _______ and _______ tumors Alpha-fetoprotein: _______ carcinoma Human chorionic gonadotropin: ________

surface epithelial Thecomas and granulosa cell Sertoli-Leydig and hilar cell Yolk sac Choriocarcinoma

Placenta infections Ascending infection: Bacteria may enter the _________ and cross the ___________ or infect the ___________. Premature ______________ provides an easy route for infection.

cervical canal ; foetal membranes placental disk rupture of membranes

Gestational trophoblastic disease Benign _________ mole, Locally __________ mole, ______carcinoma

hydatidiform invasive Chorio

Hydatidiform mole Is a _________ abnormality of the placenta that occurs in ________ resulting from faulty _________. consists of numerous _______ and occurs in two forms • _________ • ______ mole

developmental placenta pregnancies; fertilization. vesicles • Complete • Partial mole

Complete hydatidiform mole _____ karyotype: ______of 23 chromosomes are derived from ____________________. This process, called androgenesis, is accompanied by a _____________ and the reduplication of the ____________ contributed by the sperm.

46XX; Both sets the father loss of maternal chromosome male chromosome set

Partial mole: In this condition, the _______ _______ is attached to a ____________ foetus. Partial moles result from __________ (i.e., __________ by ___________), leading to _______ (_____ ,XXY).

abnormal placenta partially formed diandry fertilization by two sperm triploidy; 69

Choriocarcinoma (Common or Rare?) but highly _______ and _______ tumour composed of malignant mononuclear ___________ and multinucleated ___________.

Rare; invasive malignant cytotrophoblasts ;syncytiotrophoblasts.

Choriocarcinoma It develops in 1 of ________ pregnancies. Very young and older women (younger than _____ and older than ___ years) are most often affected.

30,000 20; 40

Choriocarcinoma Approximately 50% of choriocarcinomas arise from ______________________ , 25% originate from ______________________, and 25% arise after a ______________________

pre-existing complete hydatidiform moles residual chorionic villi after an abortion, normal pregnancy

germ cell choriocarcinomas are incurable T/F

Choriocarcinoma arising from the placenta carries ______ genes that are ______ to the host.

paternal foreign

gestational choriocarcinomas are readily (curable or incurable?)

gestational choriocarcinomas are readily curable with chemotherapy, which probably also stimulates the host's immune system in the defence against the tumour.

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Pathology of Fallopian Tubes Flashcards

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