Pathology Of Female Genitalia 3: Ovary Flashcards
Ovarian Pathology is classified into into which three (3) groups
- inflammation (rare)
- non-neoplastic cysts
- neoplasms
What is usually the cause of Ovary Inflammation
Usually secondary to spread from fallopian tube (tubo-ovarian abscess)
Apart from secondary spread from fallopian tubes, list two other causes of ovary inflammation
Appendicitis
Diverticulitis
Describe the pathogenesis of Non neoplastic ovarian cysts
An increase in ovarian production of androgen>> Impaired follicular development>> Persistent anovulation>> Development of follicular cysts>> Estrogen secretion
List three types of non-neoplastic ovarian cyst
- Follicular cyst (PCOS)
- corpus luteum cyst
- endometriotic cyst
An obese young woman with infertility, oligomenorrhea, and hirsuitism is a classic presentation of what ovarian pathology
Polycystic Ovarian Syndrome
How are chocolate/ endometriotic cysts formed
Secondary to haemorrhage within endometriotic deposits
Ovarian tumours can be classified as primary or secondary.
What are the four classifications of Primary Neoplasm
Surface (germinal/coelomic) Epithelium
Germ cell
Sex cord - stromal cells
Miscellaneous
Malignant Surface epithelium Primary Neoplasms account for what percentage of ovarian cancer
90%
What percentage of Primary Neoplasm does Surface Epithelium account for?
65%
What percentage of Primary Neoplasm does Germ Cells account for?
20%
What percentage of Primary Neoplasm does sex cord stromal cells account for?
10%
What percentage of Primary Neoplasm are miscellaneous
5%
What are the two most common subtypes of Surface Epithelial tumour
-Serous
-Mucinous
Endometrioid and Brenner are two other subtypes
Benign Surface Epithelial Neoplasms are called
Cystadenomas- because they are predominantly cystic
(Mucinous type)
How are Surface Epithelial Neoplasms classified
By histological type of cell lining the cystic cavity
What are the secretions seen in Serous and Mucinous Surface Epithelial Tumor subtypes
Serous - watery fluid
Mucinous - mucus like fluid
Serous type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
Fallopian Tube
Mucinous type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
Endocervix
Endometrioid type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
Endometrial cells
Brenner type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
Resemble urothelial cells
What is the most common ovarian neoplasm
Serous Tumours
Serous tumours account for what percentage of all ovarian tumours
25%-30%
What percentage of Serous tumours are Benign
60%
What percentage of Serous tumours are “borderline”
15%
What percentage of Serous tumours are Malignant
25%
What percentage of Serous tumours are bilateral
30-50%
Most Serous Tumours of the Ovary occur in children or adults?
Adults
Are serous tumours usually unilocular or multilocular
Multilocular
What causes the variable solidity in Serous Tumours
Papillary Intracystic Growth
Solidity increases as lesion becomes more malignant
Borderline tumours or serous tumours of low malignant potential (LMP) show all the histological features of malignancy EXCEPT
Stromal invasion
Read//
Serous Tumours are low grade Carcinomas with good prognosis
Yupp
Describe the structure of malignant serous/mucinous tumours aka cystadenocarcinoma
complex cyst with a thick shaggy lining
What percentage of Mucinous Neoplasms are bilateral?
10-20%
What percentage of Mucinous Neoplasms are Benign
80%
What percentage of Mucinous Neoplasms are borderline
10%
What percentage of Mucinous Neoplasms are malignant
10%
30% of patients with Ovary Endometrioid have associated…
Endometrial Adenocarcinoma
What percentage of tumours do Brenner Tumours account for
1-2%
Note
Brenner tumours are predominantly solid
Ok
List three types of Sex Cord Stromal Tumours
Granulosa cell tumour
Thecoma/Fibroma
Sertoli-Leydig Tumour
Granulosa Cell Tumours occur at which age
Any age
What are sex cord-stromal tumors
these are tumors that resemble sex cord stromal tissues of the ovary
What percentage of Granulosa Cell Tumours produce excessive oestrogen
25%-75%
What is the effect of Granulosa Cell Tumours in Children
Precocious puberty
What is the effect of Granulosa Cell Tumours at the reproductive age
Menstrual irregularities
What is the effect of Granulosa Cell Tumours at the older age
Post menopausal bleeding
Do most Granulosa Cell Tumours behave malignant or Benign
Malignant with minimal risk for metastases
What is the origin of a Thecoma
Originates from Theca Cell
Describe the texture and appearance of a Thecoma
Solid and firm
Do Thecomas produce oestrogen
They may, and they may also produce androgens
True or False
Thecomas are almost always benign
True
Describe Fibromas
Solid, invariably benign
What is Meig’s Syndrome
It is defined as the triad of begnin ovarian tumour with
ascites and
pleural effusion
That resolves after resection of the tumour
It is defined as the triad of begnin ovarian tumour with
ascites and
pleural effusion
That resolves after resection of the tumour
Meig’s Syndrome
What is the result of the excess androgen secretion by Sertoli-Leydig Cell Tumours
Virilization
Describe Sertoli-Leydig Cell Tumours of the Ovary
Resemble Sertoli and Leydig Cells of Testis
Predominantly solid
What is a Dysgerminoma
Germ Cell Tumour
List four thpes of Germ Cell Tumours
Dysgerminoma
Yolk sac tumour
Choriocarcinoma
Teratoma
Germ Cell Tumours account for what percentage of ovarian tumours
20%
What is the most common Ovarian Tumour in girls and young women
Germ Cell Tumours
Are all Dysgerminomas malignant or Benign
Malignant
What is the most common MALIGNANT germ cell tumour
Dysgerminoma
What is the survival time span for a patient with Dysgerminomas
95% 5 yr survival rate
Describe the histology of Yolk sac tumours
Schiller-Duva bodies (glomerulus li
What protein is secreted by Yolk sac tumour
Alpha Fetoprotein
Describe the tissue seen in choriocarcinoma
Trophoblast and syncitiotrophoblast
And highly malignant
What is the most common type of germ cell tumor
Benign Cystic Teratoma (dermoid cyst)
Are Benign Cystic Teratomas Multilocular or Unilocular
Both
Describe the sebaceous material of a benign Cystic Teratoma
Cheesy Porridge like Sebaceous material with matted hair
What is the prognosis of Solid Teratomas
Invariably Malignant
Why are solid Teratomas invariably malignant
Due to immaturity of the tissues
What is the presentation of Ovarian Tumours
Asymptomatic, pain, mass, signs of malignancy, hormonal changes
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
A patient with a choriocarcinoma may test positive for which test
hCG
In terms of the age group affected, what is the main difference between cystadenomas and cystadenocarcinomas
Cystadenomass affect pre-menopausal women while cystadenocarcinomas affect post-menopausal women