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Year 2 OBGYN > Pathology of the ovary > Flashcards

Pathology of the ovary Flashcards

1
Q

how do ovarian disease manifest?

A

adnexal masses

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2
Q

what is the incidence of gynecological cancers? prognosis?

A

incidence: endometrial > ovarian > cervical

worst prognosis: ovarian > cervical > endometrial

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3
Q

what are the 7 types of ovarian cysts?

A
  • follicular
  • corpus luteum
  • theca-lutein
  • hemorrhagic
  • dermoid
  • endometrioid
  • inflammatory
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4
Q

what are the 7 benign ovarian tumors?

A
  • serous cystadenoma
  • mucinous cystadenoma
  • endometrioma
  • mature cystic teratoma (dermoid cyst)
  • brenner tumor
  • fibroma
  • thecoma
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5
Q

what are the 8 malignant ovarian tumors?

A
  • serous cystadenocarcinoma
  • mucinous cystadenocarcinoma
  • granulosa cell tumor
  • immature teratoma
  • dysgerminoma
  • choriocarcinoma
  • yolk sac (endodermal sinus) tumor
  • krukenberg tumor
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6
Q

what is the most common ovarian mass in young women?

A

follicular cyst

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7
Q

what is the cause / pathogenesis of follicular cyst?

A

distention of unruptured graafian follicle

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8
Q

what is the pathogenesis of corpus luteum cyst?

A

cystic enlargement of corpus luteum with central hemorrhage, may rupture - peritoneal reaction with fibrosis and hemorrhage mimicking endometriosis

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9
Q

diagnosis of endometriosis should have an exclusion of what type of ovarian cyst?

A

corpus luteum cyst

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10
Q

theca-lutein cysts are due to what cause?

A

gonadotropin stimulation

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11
Q

are theca-lutein cysts unilateral or bilateral? single or multiple?

A

often bilateral

often multiple

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12
Q

theca-lutein cysts are associated with what conditions?

A

chroriocarcinoma

moles

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13
Q

what is the cause of hemorrhagic cysts?

A

blood vessel rupture in cyst wall - cyst grows with increased blood retention

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14
Q

what is the most common ovarian tumor in women 20-30 yo?

A

dermoid cyst

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15
Q

what type of tumor is a dermoid cyst?

A

germ cell tumor (mature teratoma)

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16
Q

why can dermoid cysts present as hyperthyroidism? what si the term for this?

A

could contain functional thyroid tissue

stuma ovarii

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17
Q

how does an endometrioid cyst occur?

A

endometriosis within ovary with cyst formation (varies with menstrual cycle - chocolate cyst)

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18
Q

how does nulliparity affect ovarian cancer risk?

A

increases risk

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19
Q

what are the four classifications of ovarian neoplasms?

A
  • surface epithelial 65-70%
  • stromal 15-20%
  • germ cell tumors 5-10%
  • metastatic tumors 5%
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20
Q

what is the most common ovarian tumor age 20-50?

A

serous cystadenoma (benign)

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21
Q

serous cystadenomas are lined by what cell type? what is their gross morphology?

A

fallopian-like epithelium: tall, ciliated secretory columnar

smooth, thin walled, filled with serous fluid

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22
Q

what is the gross morphology of mucinous cystadenoma?

A
  • multiloculated

- often unilateral and large

23
Q

histogenetically, mucinous cystadenomas are linked to what structure? why?

A

cervix

epithelial lining consists of tall, mucus secreting columnar epithelium (but NOT ciliated)

24
Q

are most mucinous cystadenomas benign, borderline, or malignant?

A

benign (80%)

25
Q

where does an endometrioma arise?

A

from growth of ectopic endometrial tissue

26
Q

what is a brenner tumor? what is unique about it?

A
  • adenofibroma with nodules of transitional type epithelial cells in a dense fibrous stroma
  • contains TRANSITIONAL epithelial cells
27
Q

what is the gross appearance of a brenner tumor? histologic?

A
  • GROSS: solid tumor that is pale yellow-tan in color and appears encapsulated, unilateral
  • HISTOLOGIC: coffee bean nuclei on H&E
28
Q

brenner tumors are usually associated with what other type of tumor?

A

teratoma

29
Q

which type of ovarian tumor contains transitional type epithelium?

A

brenner tumor

30
Q

what type of tumor?

  • bundles of spindle-shaped fibroblasts
  • pulling sensation in groin
  • meigs syndrome - triad of ovarian fibroma + ascites + hyrothorax
A

fibroma

31
Q

what is meigs syndrome?

A

triad of

  • ovarian fibroma
  • ascites
  • hyrothorax
32
Q

how does a thecoma usually present?

A

abnormal uterine bleeding in a postmenopausal woman

33
Q

what may thecomas produce?

A

estrogen

34
Q

what is the most common ovarian malignancy? is it usually unilateral or bilateral?

A

serous cystadenocarcinoma

usually bilateral

35
Q

in what type of ovarian cancer are psammoma bodies found?

A

serous cystadenocarcinoma

36
Q

what is the histology of serous cystadenocarcinoma?

A
  • papillary growth
  • hyperchromatic cells
  • psammoma bodies (small concretions of dystrophic calcification)
37
Q

what are the three main features of mucinous cystadenocarcinoma?

A
  • complex architecture
  • nuclear atypia
  • stromal invasion
38
Q

what is pseudomyxoma peritonei? in which ovarian tumor is it seen?

A
  • intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor
  • mucinous cystadenocarcinoma
39
Q

an immature teratoma is most typically represented by what type of tissue?

A

immature / embryonic like neural tissue

40
Q

which is more likely to contain thyroid tissue - immature or mature teratoma?

A

mature

41
Q

are immature teratomas aggressive or non-aggressive?

A

aggressive

42
Q

what are call-exner bodies? where are they seen?

A
  • small eosinophilic fluid-filled spaces between granulosa cells, resemble primordial follicles
  • granulosa cell tumor (malignant)
43
Q

what can granulosa cell tumors secrete?

A

estrogen and progesterone

44
Q

dysgerminomas are common in which age group?

A

adolescents

45
Q

what is the histological appearance of dysgerminoma?

A

fried egg cells

46
Q

“fried egg cells” is indicative of which tumor?

A

dysgerminoma

47
Q

dysgerminomas have which tumor markers? which transcription factors are expressed for diagnosis?

A
  • hCG, LDH

- Oct3, Oct4, c-KIT

48
Q

choriocarcinoma is malignancy of what cell type?

A

trophoblastic tissue (cytotrophoblasts, syncytiotrophoblastic tissue)

49
Q

how do choriocarcinomas present?

A
  • abnormal BHCG
  • SOB
  • hemoptysis
50
Q

are choriocarcinomas responsive to chemotherapy?

A

yes, very

51
Q

what are schiller-duval bodies? in which tumor type are they seen?

A
  • resemble glomeruli

- yolk sac tumors

52
Q

what is the tumor marker for yolk sac tumors?

A

AFP

53
Q

what is a krukenberg tumor? what cell type is present?

A
  • GI malignancy which metastasizes to the ovaries

- mucin secreting signet cell adenocarcinoma

Year 2 OBGYN (33 decks)

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