Pathology of Fallopian tubes and ovaries Flashcards
Recap of reproductive embryology:
- reproductive development diverges after 7 weeks
- If ___ region on Y-chromosome then male repro, if not then female
- gonads arise from u______ r____
- mesonephric/Wolffian ducts remain for males
- paramesonephric/Mullerian ducts remain for females
Recap of reproductive embryology:
- reproductive development diverges after 7 weeks
- If SRY region on Y-chromosome then male repro, if not then female
- gonads arise from urogenital ridges
- mesonephric/Wolffian ducts remain for males
- paramesonephric/Mullerian ducts remain for females
Males: SRY makes gonads become testis
- testis have spermatogonia, Leydig and Sertoli cells
- Testosterone from _____ cells supports mesonephric/Wolffian ducts
- _____________ develops prostate, penis and scrotum
- Anti-Mullerian Hormone from _____ cells regresses paramesonephric ducts
Mesonephric ducts makes:
rete testis>______ _____>epididymis>vas deferens>seminal vesicle>bladder trigone
Urogenital sinus makes:
bladder>______ ____>bulbourethral gland>______
Pics in folder.
Males: SRY makes gonads become testis
- testis have spermatogonia, Leydig and Sertoli cells
- Testosterone from Leydig cells supports mesonephric/Wolffian ducts
- Dihydrotestosterone develops prostate, penis and scrotum
- Anti-Mullerian Hormone from Sertoli cells regresses paramesonephric ducts
Mesonephric ducts makes:
rete testis>efferent ductules>epididymis>vas deferens>seminal vesicle>bladder trigone
Urogenital sinus makes:
bladder>prostate gland>bulbourethral gland>urethra
Pics in folder.
Females: without SRY gonad becomes ovary
- ovary has oogonia, _____ ____ and surface epithelium
- Without ________ mesonephric duct regresses
- Without ___-_____ _______ the paramesonephric ducts remains
Paramesonephric ducts makes: oviducts/FTs>_____>cervix>upper 1/3 of vagina>vestibule
Urogenital sinus makes: bladder (except trigone)>bulbourethral gland>_____>lower 2/3 of vagina
Females: without SRY gonad becomes ovary
- ovary has oogonia, stromal cells and surface epithelium
- Without testosterone mesonephric duct regresses
- Without Anti-mullerian hormone the paramesonephric ducts remains
Paramesonephric ducts makes: oviducts/FTs>uterus>cervix>upper 1/3 of vagina>vestibule
Urogenital sinus makes: bladder (except trigone)>bulbourethral gland>urethra>lower 2/3 of vagina
Fallopian tubes / oviducts / uterine tubes
- lined by ______ ______ ________
- has complex plicae
- layers of _____ muscle
- outer layer of peritoneum
Fallopian tubes / oviducts / uterine tubes
- lined by ciliated columnar epithelium
- has complex plicae
- layers of smooth muscle
- outer layer of peritoneum
Pathology of Fallopian tubes
- ________ can affect the FTs and is a pelvic inflammatory disease
(means ‘inflamm of fallopian tubes’) - usually caused by infection (e.g. - think of some examples - )
- it is an _______ infection (meaning it has travelled upwards)
- Symptoms: fever, lower abdominal/pelvic pain, pelvic masses if tubes distended, secretions
Pathology of Fallopian tubes
- ‘Salpingitis’ can affect the FTs and is a pelvic inflammatory disease
(means ‘inflamm of fallopian tubes’) - usually caused by infection (e.g. chlamydia, streptococci, staphylococci, gonorrhea)
- it is an ascending infection (meaning it has travelled upwards)
- Symptoms: fever, lower abdominal/pelvic pain, pelvic masses if tubes distended, secretions
Complications of Salpingitis:
- a_______ of tube to ovary (needs incised)
- tubo-ovarian a_____ (collection of pus)
- damage to tube can mean i______
- ruptured tubal ectopic pregnancy can be life threatening
- e_________ commonly affects ovarian tubes too
Complications of Salpingitis:
- adherence of tube to ovary (needs incised)
- tubo-ovarian abscess (collection of pus)
- damage to tube can mean infertility
- ruptured tubal ectopic pregnancy can be life threatening
- endometriosis commonly affects ovarian tubes too
Fallopian tube malignancies:
- Primary adenocarcinomas arisng from FT are rare
- Most common is _______ _____ _______ / _____ _______
- E________ carcinomas also seen
These carcinomas occur in women with BRCA1 mutations. They also commonly affect the peritoneum and omentum.
Fallopian tube malignancies:
- Primary adenocarcinomas arsing from FT are rare
- Most common is papillary serous carcinoma / serous carcinoma
- Endometriod carcinomas also seen
These carcinomas occur in women with BRCA1 mutations. They also commonly affect the peritoneum and omentum.
‘STIC’
= _____ ____ ________ ______
- this is abnormal epithelium in ____ FT (where it opens near the ovary)
- limited by _______ _______ so technically ‘carcinoma in situ’
- In STIC nuclear atypia clearly seen
- Precursor for high grade serous carcinoma / papillary serous carcinoma
‘STIC’
= serous tubal intraepithelial carcinoma
- this is abnormal epithelium in distal FT (where it opens near the ovary)
- limited by basement membrane so technically ‘carcinoma in situ’
- In STIC nuclear atypia clearly seen
- Precursor for high grade serous carcinoma / papillary serous carcinoma
Pathology of Ovaries 1
Non-neoplastic cysts include:
- _______/______ cyst (ovarian cyst covered in mature squamous epithelium)
- _______ cyst (egg isn’t released from follicle and becomes fluid-filled cyst)
- _____ _____ cysts (corpus luteum doesn’t breakdown and fills with blood or fluid)
Pathology of Ovaries 1
Non-neoplastic cysts include:
- inclusion/epidermoid cyst (ovarian cyst covered in mature squamous epithelium)
- follicular cyst (egg isn’t released from follicle and becomes fluid-filled cyst)
- corpus luteal cysts (corpus luteum doesn’t breakdown and fills with blood or fluid)
Pathology of Ovaries 2
Polycystic ovaries:
- ___________ (irregular/infrequent periods)
- ovaries enlarged (x2)
- many subcortical cysts
- thick fibrotic surrounding cysts
- cysts lined by granulosa cells and have core of hypertrophic + hyperplastic theca interna (produced lots of androgens)
Pathology of Ovaries 2
Polycystic ovaries:
- oligomenorrhea (irregular/infrequent periods)
- ovaries enlarged (x2)
- many subcortical cysts
- thick fibrotic surrounding cysts
- cysts lined by granulosa cells and have core of hypertrophic + hyperplastic theca interna (produced lots of androgens)
Pathology of Ovaries 3
Ovarian Neoplasms:
Can come from:
- ______ (coelomic) ________
- ____ cells
- ___ ____/_____ ___
Pathology of Ovaries 3
Ovarian Neoplasms:
Can come from:
- surface (coelomic) epithelium
- germ cells
- sex cord/stromal cells
Surface epithelial tumours of ovaries 1
(although thought to arise from coelomic mesothelium on surface of ovary)
Risks:
- _______ (not having children) _______ risk
- ___ _________ use can ______ risk
Surface epithelial tumours of ovaries
(although thought to arise from coelomic mesothelium on surface of ovary)
Risks:
- nulliparity (not having children) increases risk
- oral contraceptive reduces risk
Ovarian cancer genes
- ____ mutations
- ____ mutations (poor prognosis)
- ____ mutations mostly in mucinous cystadenocarcinomas
- ____ mutations (common, and usually in high grade serous cancers)
Ovarian cancer genes
- BRCA mutations
- Her2 mutations (poor prognosis)
- KRAS mutations mostly in mucinous cystadenocarcinomas
- p53 mutations (common, and usually in high grade serous cancers)
Surface epithelial tumours of ovaries 2
Benign lesions:
- cystic (_________)
- cystic + stromal (___________)
Borderline/intermediate:
inbetween
Malignant lesions:
- cystic (_____________)
- solid (___________)
These carcinomas can be:
- > _____ (high grade or low grade)
- > ________
- > endometrioid
Surface epithelial tumours of ovaries 2
Benign lesions:
- cystic (cystadenoma)
- cystic + stromal (cystadenofibroma)
Borderline/intermediate:
inbetween
Malignant lesions:
- cystic (cystadenocarcinoma)
- solid (adenocarcinoma)
These carcinomas can be:
- > serous (high grade or low grade (HGSC/LGSC) )
- > mucinous
- > endometrioid
High grade serous carcinoma
(HGSC), usually ___ and _____ are affected.
For Low grade serous carcinoma (LGSC) and borderline tumours, usually ____ and ____ are affected.
High grade serous carcinoma
(HGSC), usually p53 and BRCA1 are affected.
Low grade serous carcinoma (LGSC), usually KRAS and BRAF are affected.