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MS2 - Life Cycle > Pathology of the Ovary > Flashcards

Pathology of the Ovary Flashcards

1
Q

_______________ line the fallopian tube.

A

Ciliated columnar epithelium

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2
Q

Most ectopic pregnancies occur in the __________.

A

fallopian tube (90%)

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3
Q

What is the frequency of ectopic pregnancy?

A

About 1/150

• Note: the risk increases with a history of pelvic inflammatory disease.

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4
Q

One of the biggest problems occurring with ectopic pregnancy is ________________.

A

that the developing embryo needs a deep layer of tissue to dive into

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5
Q

The classic gross description of endometriosis is _____________.

A

a dark, “chocolate cyst”

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6
Q

About _______ of women have endometriosis.

A

10%

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7
Q

What are signs of endometriosis?

A

Infertility, pelvic pain, and dysmenorrhea

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8
Q

Describe polycystic ovary syndrome.

A
  • 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
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9
Q

What are some factors that increase and decrease ovarian cancer?

A

•Increase risk:

  • infertility
  • unopposed estrogen for greater than 10 years
  • family history (most important)

• Decrease risk:

  • OCPs
  • gynecologic surgery
  • pregnancies
  • breast feeding
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10
Q

The most common subtype of ovarian cancer seen in women with BRCA mutations is ____________.

A

serous cystadenocarcinoma

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11
Q

The mortality in those with BRCA mutations is due to _______________.

A

ovarian cancer (not breast cancer)

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12
Q

Most hereditary disposition to breast and ovarian cancer is due to ______________.

A

unknown etiologies (in 85% of cases)

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13
Q

What are the symptoms of ovarian cancer?

A

All incredibly nonspecific:

  • bloating
  • pelvic or abdominal pain
  • early satiety
  • fatigue
  • dyspareunia
  • constipation
  • metrorrhagia
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14
Q

Most ovarian cancers (70% of all neoplasms and 90% of malignant neoplasms) arise from _______________.

A

surface epithelium (often the fimbriated end of the fallopian tube)

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15
Q

The second-most common ovarian cancer (20% of all neoplasms and 5% of malignant neoplasms) arise from _____________.

A

germ cells

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16
Q

80% of ovarian masses are ____________.

A

benign

17
Q

What is unique about the metastasis of ovarian malignancies?

A

They can directly seed the peritoneum and thus spread extremely rapidly.

18
Q

Describe the technique that is used to evaluate the spread of ovarian cancer.

A

Saline is washed around the peritoneum and sucked up. The fluid is then cytologically examined for peritoneal seeding.

19
Q

The most frequent subtype of ovarian tumors is ___________.

A

serous

20
Q

______________ is the only ovarian tumor to start on (and occasionally stay on) the external surface of the ovary.

A

Serous borderline tumor

21
Q

One thing that is unique about benign mucinous tumors is that _____________.

A

they express normal and abnormal tissues (whereas other benign neoplasms generally display uniform abnormality)

22
Q

Almost all cases of _____________ carcinoma are associated with endometriosis.

A

clear cell

23
Q

What are hobnail cells?

A

Naked nuclei bulging into cysts (found in CCC)

24
Q

Most germ cell tumors in the ovary are _______________.

A

teratomas

25
Q

In contrast to in men, most germ cells tumors in women are ____________.

A

not mixed

26
Q

What histologic finding signifies an immature teratoma?

A

Immature neuroepithelium

27
Q

What are Schiller-Duval bodies?

A
  • Glomeruloid structures with central blood vessels and surrounding neoplastic cells
  • Associated with yolk sac tumors
28
Q

What cell type is often seen in those with granulosa cell tumors?

A

Call-Exner bodies: repeat primitive follicles; nuclear inclusions

29
Q

Women with ___________ will often display androgenism.

A

Leydig/Sertoli tumors (because the tumors recapitulate male testes)

30
Q

Mucin-producing tumors in the abdomen can arise from ________________.

A

appendiceal tumors

31
Q

You will often see hemosiderin-laden macrophages in _____________.

A

endometriosis

32
Q

Any kind of inflammation can raise the future risk of ectopic pregnancy, so even ____________ can raise risk.

A

abdominal surgery

33
Q

What is the five-year survival for ovarian cancer?

A

41%

34
Q

If you see a verrucous ovarian mass that does not have hemorrhages or necrosis, what is likely the diagnosis?

A

Borderline

35
Q

What are the four kinds of surface epithelial ovarian tumors?

A

Serous (papillary architecture)
Mucinous (goblet cells and little pellets of mucus)
Endometrioid (same as normal endometrium –pseudostratified columnar)
Clear cell

(“Seers Make Everything Clear.”)

36
Q

Which have better prognoses, germ cell tumors or surface epithelium tumors?

A

Germ cell tumors –excellent survival rate of ~ 90%

MS2 - Life Cycle (61 decks)

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