Pathology Of Female Genitalia 3: Ovary Flashcards
(113 cards)
1
Q
Ovarian Pathology is classified into into which three (3) groups
A
- inflammation (rare)
- non-neoplastic cysts
- neoplasms
2
Q
What is usually the cause of Ovary Inflammation
A
Usually secondary to spread from fallopian tube (tubo-ovarian abscess)
3
Q
Apart from secondary spread from fallopian tubes, list two other causes of ovary inflammation
A
Appendicitis
Diverticulitis
4
Q
Describe the pathogenesis of Non neoplastic ovarian cysts
A
An increase in ovarian production of androgen>> Impaired follicular development>> Persistent anovulation>> Development of follicular cysts>> Estrogen secretion
5
Q
List three types of non-neoplastic ovarian cyst
A
- Follicular cyst (PCOS)
- corpus luteum cyst
- endometriotic cyst
6
Q
An obese young woman with infertility, oligomenorrhea, and hirsuitism is a classic presentation of what ovarian pathology
A
Polycystic Ovarian Syndrome
7
Q
How are chocolate/ endometriotic cysts formed
A
Secondary to haemorrhage within endometriotic deposits
8
Q
Ovarian tumours can be classified as primary or secondary.
What are the four classifications of Primary Neoplasm
A
Surface (germinal/coelomic) Epithelium
Germ cell
Sex cord - stromal cells
Miscellaneous
9
Q
Malignant Surface epithelium Primary Neoplasms account for what percentage of ovarian cancer
A
90%
10
Q
What percentage of Primary Neoplasm does Surface Epithelium account for?
A
65%
11
Q
What percentage of Primary Neoplasm does Germ Cells account for?
A
20%
12
Q
What percentage of Primary Neoplasm does sex cord stromal cells account for?
A
10%
13
Q
What percentage of Primary Neoplasm are miscellaneous
A
5%
14
Q
What are the two most common subtypes of Surface Epithelial tumour
A
-Serous
-Mucinous
Endometrioid and Brenner are two other subtypes
15
Q
Benign Surface Epithelial Neoplasms are called
A
Cystadenomas- because they are predominantly cystic
(Mucinous type)
16
Q
How are Surface Epithelial Neoplasms classified
A
By histological type of cell lining the cystic cavity
17
Q
What are the secretions seen in Serous and Mucinous Surface Epithelial Tumor subtypes
A
Serous - watery fluid
Mucinous - mucus like fluid
18
Q
Serous type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
A
Fallopian Tube
19
Q
Mucinous type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
A
Endocervix
20
Q
Endometrioid type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
A
Endometrial cells
21
Q
Brenner type cells of Surface Epithelial Neoplasms resemble cells of which FGT structure
A
Resemble urothelial cells
22
Q
What is the most common ovarian neoplasm
A
Serous Tumours
23
Q
Serous tumours account for what percentage of all ovarian tumours
A
25%-30%
24
Q
What percentage of Serous tumours are Benign
A
60%
25
What percentage of Serous tumours are “borderline”
15%
26
What percentage of Serous tumours are Malignant
25%
27
What percentage of Serous tumours are bilateral
30-50%
28
Most Serous Tumours of the Ovary occur in children or adults?
Adults
29
Are serous tumours usually unilocular or multilocular
Multilocular
30
What causes the variable solidity in Serous Tumours
Papillary Intracystic Growth
Solidity increases as lesion becomes more malignant
31
Borderline tumours or serous tumours of low malignant potential (LMP) show all the histological features of malignancy EXCEPT
Stromal invasion
32
Read//
Serous Tumours are low grade Carcinomas with good prognosis
Yupp
33
Describe the structure of malignant serous/mucinous tumours aka cystadenocarcinoma
complex cyst with a thick shaggy lining
34
What percentage of Mucinous Neoplasms are bilateral?
10-20%
35
What percentage of Mucinous Neoplasms are Benign
80%
36
What percentage of Mucinous Neoplasms are borderline
10%
37
What percentage of Mucinous Neoplasms are malignant
10%
38
30% of patients with Ovary Endometrioid have associated...
Endometrial Adenocarcinoma
39
What percentage of tumours do Brenner Tumours account for
1-2%
40
Note
| Brenner tumours are predominantly solid
Ok
41
List three types of Sex Cord Stromal Tumours
Granulosa cell tumour
Thecoma/Fibroma
Sertoli-Leydig Tumour
42
Granulosa Cell Tumours occur at which age
Any age
43
What are sex cord-stromal tumors
these are tumors that resemble sex cord stromal tissues of the ovary
44
What percentage of Granulosa Cell Tumours produce excessive oestrogen
25%-75%
45
What is the effect of Granulosa Cell Tumours in Children
Precocious puberty
46
What is the effect of Granulosa Cell Tumours at the reproductive age
Menstrual irregularities
47
What is the effect of Granulosa Cell Tumours at the older age
Post menopausal bleeding
48
Do most Granulosa Cell Tumours behave malignant or Benign
Malignant with minimal risk for metastases
49
What is the origin of a Thecoma
Originates from Theca Cell
50
Describe the texture and appearance of a Thecoma
Solid and firm
51
Do Thecomas produce oestrogen
They may, and they may also produce androgens
52
True or False
Thecomas are almost always benign
True
53
Describe Fibromas
Solid, invariably benign
54
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
55
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
56
What is the result of the excess androgen secretion by Sertoli-Leydig Cell Tumours
Virilization
57
Describe Sertoli-Leydig Cell Tumours of the Ovary
Resemble Sertoli and Leydig Cells of Testis
| Predominantly solid
58
What is a Dysgerminoma
Germ Cell Tumour
59
List four thpes of Germ Cell Tumours
Dysgerminoma
Yolk sac tumour
Choriocarcinoma
Teratoma
60
Germ Cell Tumours account for what percentage of ovarian tumours
20%
61
What is the most common Ovarian Tumour in girls and young women
Germ Cell Tumours
62
Are all Dysgerminomas malignant or Benign
Malignant
63
What is the most common MALIGNANT germ cell tumour
Dysgerminoma
64
What is the survival time span for a patient with Dysgerminomas
95% 5 yr survival rate
65
Describe the histology of Yolk sac tumours
Schiller-Duva bodies (glomerulus li
66
What protein is secreted by Yolk sac tumour
Alpha Fetoprotein
67
Describe the tissue seen in choriocarcinoma
Trophoblast and syncitiotrophoblast
| And highly malignant
68
What is the most common type of germ cell tumor
Benign Cystic Teratoma (dermoid cyst)
69
Are Benign Cystic Teratomas Multilocular or Unilocular
Both
70
Describe the sebaceous material of a benign Cystic Teratoma
Cheesy Porridge like Sebaceous material with matted hair
71
What is the prognosis of Solid Teratomas
Invariably Malignant
72
Why are solid Teratomas invariably malignant
Due to immaturity of the tissues
73
What is the presentation of Ovarian Tumours
Asymptomatic, pain, mass, signs of malignancy, hormonal changes
74
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
75
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
76
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
76
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
77
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
77
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
78
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
79
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
80
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
81
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
81
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
81
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
81
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
81
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
81
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
82
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
83
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
84
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
85
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
86
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
86
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
86
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
86
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
86
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
87
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
88
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
89
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
90
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
91
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
92
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
92
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
92
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
92
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
93
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
94
Sertoli-Leydig Tumours of the ovarary are often associated with what clinical presentation
Hirsuitism
Virilization
As a result of angrogen production
94
WHat is the 2nd most common type of ovarian tumour
Germ Cell Tumour
94
Cystadenomas most commonly arise in which age group
Premenopausal women (30-40)
94
Describe the structure of benign mucous/serous tumours of the ovary aka (cystadenomas)
single cyst with a simple flat lining
94
A patient with a choriocarcinoma may test positive for which test
hCG
94
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
