Pathology of Fallopian Tubes Flashcards

1
Q

Inflammations of the fallopian tubes

__________ inflammations
• ________ (60%)
• __________ organism

____________ _____________

Others
• Parasites Schistosomiasis, Enterobiosis
• Fungi Actinomycosis

A

Suppurative

Gonococci ;Pyogenic

Tuberculous Salpingitis

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2
Q

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

A

abnormal implantation

fertilized ovum ; outside

uterus.

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3
Q

Ectopic pregnancy

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

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

A

1% ; fallopian tubes,

the ovary

the pelvic peritoneum

surface of the abdominal organs.

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4
Q

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 _________.

A

distended fallopian tube

laparoscopic

resected together

embryo; placenta

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5
Q

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

• Tumour-like lesions
–_____________

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

A

hydatids of Morgani; Paratubal cysts

Endometriosis

Adenomatoid ; Adenocarcinoma

BRCA 1 mutations

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6
Q

Most cysts of the fallopian tube are of no clinical significance

T/F

A

T

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7
Q

Ovarian cysts

Ovarian cysts are ________-filled cavities lined by ___________ .

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

A

fluid ; epithelium.

small; solitary

no clinical problems.

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8
Q

Ovarian cysts

• Majority are ______ cysts.

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

A

follicular

corpora lutea

surface epithelium

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9
Q

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

A

Stein- Leventhal syndrome

hypothalamic-pituitary-ovarian-adrenal axis.

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10
Q

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 ________.

A

fibrosis

superficial cortex

hormonal.

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11
Q

Clinical features of polycystic ovary syndrome

Menstrual ________, (_________ and ____________)

Persistent _________ in 40% of cases

_________

Signs of _______, such as ________.

_______ is a major problem.

A

irregularities; oligomenorrhea and amenorrhea

anovulation; obesity

virilization; hirsutism

Infertility

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12
Q

Poly cystic ovaries

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

A

follicular cysts

superficial fibrosis

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13
Q

Ovarian tumours

________ tumours are more common.

A

Benign

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14
Q

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.

A

45; 15

50; 3

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15
Q

Ovarian tumours- classification

Tumours of _____________
____________ tumors
_____________________tumors
______ tumours

A

surface epithelium

Germ cell

Sex cord stromal

Benign

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16
Q

Types Serous tumours

They are typically _______ and filled with ______ serous fluid.

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

A

cystic ; clear

benign, serous cystadenomas

borderline ;serous cystadenocarcinomas

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17
Q

Types Serous tumours

These tumours can also be solid

T/F

A

T

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18
Q

Serous tumors

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

A

25

50

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19
Q

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.

A

Poorly

dysgenesis; Familial

BRCA1 and BRCA2

breast

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20
Q

Serous tumor classification

List them

A

Low- and high -grade serous carcinoma

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21
Q

Serous tumor classification

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

A

KRAS or BRAF

p53.

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22
Q

Serous tumor classification

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

A

p53 ; KRAS or BRAF.

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23
Q

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

A

high

p53

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24
Q

Mucinous tumours

Primary Mucinous tumours rare usually _____lateral.

A

uni

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25
Q

Primary Mucinous tumours

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

A

KRAS

Benign mucinous cystadenomas

Mucinous borderline tumors

Primary ovarian mucinous carcinomas

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26
Q

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

A

Rare

endometriosis; endometrial carcinoma

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27
Q

Endometrioid Carcinoma

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

A

PTEN

KRAS

β-catenin

microsatellite instability

28
Q

Germ cell tumors

•________
• _____________
• _________ carcinoma
• ________ tumor

A

Teratoma
• Dysgerminoma
• Embryonal carcinoma
• Yolk sac

29
Q

Germ cell tumors

Teratoma
– _________
– _________
– _________ or _________ teratoma

A

Mature
– Immature
– Monodermal or specialized

30
Q

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 ____________

A

seminoma ; testis

More malignant

endodermal sinus tumour

Malignant; alpha- fetoprotein

31
Q

The most common Germ cell tumor is ???

A

Teratoma

32
Q

Monodermal Teratoma

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

A

Unilateral ± teratoma

contralateral

33
Q

Monodermal Teratoma

Struma Ovarii –
• may cause ____________

A

hyperthyroidism

34
Q

Monodermal Teratoma

Struma Carcinoid-
• Thought to arise from the ———- epithelium of the teratoma

• May produce _________ resulting in carcinoid tumour
• Less than ____% metastasize.

A

intestinal

5-hydroxytryptamine

2%.

35
Q

Monodermal Teratoma

Struma _______
Struma __________\

A

Struma Ovarii
Struma Carcinoid

36
Q

Immature teratoma
• The component tissues resemble _________ and __________ tissue.

• Occurs in __________ adolescents and (young or old?) women
• Predominantly (solid or cystic?)
• Grading based on the ________________________

A

embryonal and immature fetal

prepubertal adolescents ; young

solid; presence of neuroepithelium

37
Q

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.

A

seminoma of the testis.

half ; 2nd and 3rd

HCG.; no __________

dysgenesis ; pseudohermaphroditism

38
Q

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

A

Rare; 2nd

Uni; rapidly

α-fetoprotein and α1-antitrypsin

39
Q

Yolk sac tumour

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

A

Schiller-Duval

hyaline droplets

α-fetoprotein

Good

40
Q

Choriocarcinoma

(Common or Rare?) , highly (benign or malignant?) tumor that secretes _________

Usually diagnosed in _________ (boys or girls?)

Associated with other germ cell tumours

A

Rare ; malignant

secretes human chorionic gonadotropin (HCG)

prepubertal ; girls

Associated with other germ cell tumours

41
Q

Choriocarcinoma

Associated with other germ cell tumours

Equivalent to __________ choriocarcinoma originating from the _______ in the ______

(Poor or Good?) response to chemotherapy unlike that following ________

A

gestational choriocarcinoma

placenta; uterus

Poor ; gestation

42
Q

Fibroma:

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

A

benign ; non-functioning

fibroblasts.

43
Q

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.

A

right-sided ; pleural effusion

ascites ; Meigs

solid ; white

firm ; collagen

44
Q

Most common sex cord tumour is??

A

Fibroma

45
Q

Thecoma
Similar to ________.

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

A

fibroma

benign; solid

firm ; yellow.

46
Q

Thecoma

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

A

spindle

theca ; fat

oestrogens.

47
Q

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.

A

Juvenile and adult type

granulosa cells; oestrogens.

Solid ; yellow

firm

48
Q

Granulosa cell tumour:

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

A

granulosa cells

Call-Exner bodies

granulosa cells ; follicles.

49
Q

Granulosa cell tumour:

(Easy or Difficult?) to predict biologic behavior from histology

A

Difficult

50
Q

Sertoli-Leydig cell tumour:

– This __________ tumour contains cells resembling testicular _______ and _____ cells.

– Secrete _______ and cause ________

A

biphasic

Sertoli and Leydig cells.

androgens; virilization

51
Q

virilization

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

A

deepening ; facial and chest

acne ; clitoromegaly

amenorrhea; infertility

52
Q

Hilar cell tumors:

Usually (small or large?) ______color nodules in the _____ or the _______.

• May secrete _____________

A

small ; yellow

hilus ; ovary.

androgens

53
Q

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 ______

A

breast and gastrointestinal tract,

appendiceal

bilateral metastases

Stomach

54
Q

Hormones associated with ovarian
tumours

List 6

A

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

55
Q

Hormones associated with ovarian
tumours

Glycoprotein CA-125: Found in
—- tumors

Oestrogens: _______ and _______ tumors

Androgens: _______ and _______ tumors

Alpha-fetoprotein: _______
carcinoma

Human chorionic gonadotropin: ________

A

surface epithelial

Thecomas and granulosa cell

Sertoli-Leydig and hilar cell

Yolk sac

Choriocarcinoma

56
Q

Placenta infections

Ascending infection: Bacteria may
enter the _________ and cross
the ___________ or infect
the ___________.

Premature ______________ provides
an easy route for infection.

A

cervical canal ; foetal membranes

placental disk

rupture of membranes

57
Q

Gestational trophoblastic disease

Benign _________ mole,

Locally __________ mole,

______carcinoma

A

hydatidiform

invasive

Chorio

58
Q

Hydatidiform mole
Is a _________ abnormality of the placenta that occurs in ________ resulting from faulty _________.

consists of numerous _______
and occurs in two forms
• _________
• ______ mole

A

developmental

placenta

pregnancies; fertilization.

vesicles

• Complete
• Partial mole

59
Q

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.

A

46XX; Both sets

the father

loss of maternal chromosome

male chromosome set

60
Q

Partial mole:

In this condition, the _______ _______ is attached to a ____________ foetus.

Partial moles result from __________ (i.e.,
__________ by ___________), leading to
_______ (_____ ,XXY).

A

abnormal placenta

partially formed

diandry

fertilization by two sperm

triploidy; 69

61
Q

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

A

Rare; invasive malignant

cytotrophoblasts ;syncytiotrophoblasts.

62
Q

Choriocarcinoma
It develops in 1 of ________ pregnancies.

Very young and older women (younger than _____ and older than ___ years) are most often affected.

A

30,000

20; 40

63
Q

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

A

pre-existing complete hydatidiform moles

residual chorionic villi after an abortion,

normal pregnancy

64
Q

germ cell choriocarcinomas are incurable

T/F

A

T

65
Q

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

A

paternal

foreign

66
Q

gestational choriocarcinomas are readily (curable or incurable?)

A

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