Pathology of the Ovary Flashcards
_______________ line the fallopian tube.
Ciliated columnar epithelium
Most ectopic pregnancies occur in the __________.
fallopian tube (90%)
What is the frequency of ectopic pregnancy?
About 1/150
• Note: the risk increases with a history of pelvic inflammatory disease.
One of the biggest problems occurring with ectopic pregnancy is ________________.
that the developing embryo needs a deep layer of tissue to dive into
The classic gross description of endometriosis is _____________.
a dark, “chocolate cyst”
About _______ of women have endometriosis.
10%
What are signs of endometriosis?
Infertility, pelvic pain, and dysmenorrhea
Describe polycystic ovary syndrome.
- Most common in young women
- Presents with oligomenorrhea, obesity, and hirsutism
- Persistent anovulation due to asynchronous release of LH and FSH
- Excess androgens
- Raises risk of endometrial cancer
What are some factors that increase and decrease ovarian cancer?
•Increase risk:
- infertility
- unopposed estrogen for greater than 10 years
- family history (most important)
• Decrease risk:
- OCPs
- gynecologic surgery
- pregnancies
- breast feeding
The most common subtype of ovarian cancer seen in women with BRCA mutations is ____________.
serous cystadenocarcinoma
The mortality in those with BRCA mutations is due to _______________.
ovarian cancer (not breast cancer)
Most hereditary disposition to breast and ovarian cancer is due to ______________.
unknown etiologies (in 85% of cases)
What are the symptoms of ovarian cancer?
All incredibly nonspecific:
- bloating
- pelvic or abdominal pain
- early satiety
- fatigue
- dyspareunia
- constipation
- metrorrhagia
Most ovarian cancers (70% of all neoplasms and 90% of malignant neoplasms) arise from _______________.
surface epithelium (often the fimbriated end of the fallopian tube)
The second-most common ovarian cancer (20% of all neoplasms and 5% of malignant neoplasms) arise from _____________.
germ cells
80% of ovarian masses are ____________.
benign
What is unique about the metastasis of ovarian malignancies?
They can directly seed the peritoneum and thus spread extremely rapidly.
Describe the technique that is used to evaluate the spread of ovarian cancer.
Saline is washed around the peritoneum and sucked up. The fluid is then cytologically examined for peritoneal seeding.
The most frequent subtype of ovarian tumors is ___________.
serous
______________ is the only ovarian tumor to start on (and occasionally stay on) the external surface of the ovary.
Serous borderline tumor
One thing that is unique about benign mucinous tumors is that _____________.
they express normal and abnormal tissues (whereas other benign neoplasms generally display uniform abnormality)
Almost all cases of _____________ carcinoma are associated with endometriosis.
clear cell
What are hobnail cells?
Naked nuclei bulging into cysts (found in CCC)
Most germ cell tumors in the ovary are _______________.
teratomas
In contrast to in men, most germ cells tumors in women are ____________.
not mixed
What histologic finding signifies an immature teratoma?
Immature neuroepithelium
What are Schiller-Duval bodies?
- Glomeruloid structures with central blood vessels and surrounding neoplastic cells
- Associated with yolk sac tumors
What cell type is often seen in those with granulosa cell tumors?
Call-Exner bodies: repeat primitive follicles; nuclear inclusions
Women with ___________ will often display androgenism.
Leydig/Sertoli tumors (because the tumors recapitulate male testes)
Mucin-producing tumors in the abdomen can arise from ________________.
appendiceal tumors
You will often see hemosiderin-laden macrophages in _____________.
endometriosis
Any kind of inflammation can raise the future risk of ectopic pregnancy, so even ____________ can raise risk.
abdominal surgery
What is the five-year survival for ovarian cancer?
41%
If you see a verrucous ovarian mass that does not have hemorrhages or necrosis, what is likely the diagnosis?
Borderline
What are the four kinds of surface epithelial ovarian tumors?
Serous (papillary architecture)
Mucinous (goblet cells and little pellets of mucus)
Endometrioid (same as normal endometrium –pseudostratified columnar)
Clear cell
(“Seers Make Everything Clear.”)
Which have better prognoses, germ cell tumors or surface epithelium tumors?
Germ cell tumors –excellent survival rate of ~ 90%
