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Reproductive System > Pathology of the Ovary and Fallopian Tube > Flashcards

Pathology of the Ovary and Fallopian Tube Flashcards

1
Q

What are the four portions of the fallopian tube?

A

Infundibulum with fimbria, Ampulla, Isthmus, and Intramural division (cornua)

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2
Q

What types of cells make up the lumen of the Fallopian tube (mucosa)

A

Simple columnar epithelium with cilia and non-ciliated secretory cells

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3
Q

What are the effects of estrogen and progesterone in the fallopian tube?

A
  • Estrogen promotes ciliogenesis and mitosis
  • Progesterone stimulates secretory activity
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4
Q

What are the benign conditions of the Fallopian tube?

A
  • Salpingitis
  • Ectopic pregnancy
  • Endometriosis
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5
Q

What is Salpingitis and in what disease is it commonly seen?

A

Inflammation of the fallopian tube (commonly seen in Pelvic Inflammatory Disease)

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6
Q

What are the long term consequences of salpingitis?

A

Scarring and abnormal motility

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7
Q

What is an ectopic pregnancy?

A

Pregnancy implanted outside of the endometrial cavity (usually in the fallopian tube)

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8
Q

What is endometriosis?

What is it a risk factor for?

A

The presence of glands and stroma outside of the uterus (dysfunction/scarring affects motility)

Risk factor for ectopic pregnancy

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9
Q

Tumors of the fallopian tube tend to be associated with what gene mutation?

A

BRCA

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10
Q

What are the primary tumors of the Fallopian tube?

A

Serous carcinoma in-situ and invasive serous carcinoma

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11
Q

Describe the formation of an inclusion cyst in the ovary due to transfer of tubal epithelial cells

A
  • The fimbria envelops the ovary
  • Ovulation: The fimbria is in intimate contact with the ovary at the site of rupture
  • Tubal epithelial cells from the fimbria are dislodged and implant on the denuded surface of the ovary resulting in the formation of an inclusion cyst
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12
Q

What are the three main structures of the ovary?

A

Surface epithelium

Cortex

Medulla/Hilum

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13
Q

What types of tumors can form in the surface epithelium of the ovary?

A

Serous, Mucinous, Transitional, Endometrioid, and Clear cell tumors

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14
Q

Most surface epithelium tumors of the ovary are derived from…?

A

Coelomic epithelium (mesothelial lining)

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15
Q

What structures/cells are present in the cortex of the ovary?

A
  • Follicles
  • Germ cells
  • Sex cords (granulosa cells, luteinized cells)
  • Stromal cells
  • Smooth muscle
  • Fat
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16
Q

What is found in the medulla/hilum?

A

Hilar cells, Rete Ovarii (mesonephric tubules), blood vessels, lymphatics and nerves surrounded by loose connective tissue

17
Q

What are hilar cells?

A

Cells in the ovary that are similar to Leydig cells – secrete testosterone

18
Q

What are the most common masses found in the ovary?

A

Functional cysts

19
Q

What are the four types of functional cysts found in the ovary?

A
  • Follicular
  • Luteal (corpus luteum)
  • Inclusion cyst (cortical)
  • Hemorrhagic (corpus luteum)
20
Q

What are risk factors for tumors of the ovarian surface epithelium?

A
  • Risk factors:
    • Obesity
    • Estrogen usage for > 10 yrs
    • Family history
    • Germ line mutation in tumor suppressor genes
21
Q

What are protective factors for tumors of the ovarian surface epithelium?

A

Oral contraceptive pills

Nulliparity

22
Q

What are the three types of serous tumors in the ovary?

Which ones are cystic, which ones are solid, and which are both?

A
  • Benign serous tumors (60%)
    • Usually cystic
  • Borderline serous tumor (15%) aka serous tumor of low malignant potential
    • Can be solid and cystic in nature
  • Serous carcinoma (25%)
    • Can have solid and cystic components.
23
Q

What is the appearance of a high grade serous tumor?

A
  • Solid and Papillary
  • Pleomorphic high grade nuclei
  • Mitosis
24
Q

What are the two grades of serous carcinoma and what gene mutations are associated with each?

A
  • Low grade: KRAS, BRAF, ERBB2 mutations
  • High grade: TP53 mutation
25
Q

What are the three types of mucinous tumors of the ovarian surface epithelium? How prevalent is each?

A
  • Benign mucinous tumor (80%)
  • Borderline mucinous tumor (10%)
  • Mucinous cystadenocarcinoma (10%)
26
Q

At what age is a person most likely to have an Ovarian Surface Epithelial Tumor?

A

Reproductive Age (20-65 years)

27
Q

What does a bilateral mucinous tumor usually indicate?

A

Indicates metastasis until proven otherwise

28
Q

How do mucinous tumors of the ovary usually appear?

A

Multicystic and lined by mucin secreting cells

Mostly unilateral

29
Q

What are the two tumorogenesis pathways?

A
  • Type I - Low grade indolent neoplasms; stepwise development from borderline tumors
  • Type II - – High grade carcinoma, rapidly evolving
30
Q

Are endometrioid tumors usually benign or malignant?

A

Malignant

31
Q

What often is found concurrent with endometrioid tumors?

What mutation is associated with an endometrioid tumor?

A
  • What often is found concurrent with endometrioid tumors?
    • Endometrial carcinoma (15-30%)
  • What mutation is associated with an endometrioid tumor?
    • Mutation of PTEN suppressor gene
32
Q

Are Brenner tumors usually benign or malignant?

How do they appear histologically?

A

Mostly benign (although borderline and malignant exist)

Nests of transition type epithelium

33
Q

What structures can germ cells differentiate toward?

A
  • Oogonia (dysgerminoma),
  • Primitive embryonal tissue (embryonal carcinoma)
  • Yolk sac (endodermal sinus tumor/yolk sac tumor)
  • Placental tissue (choriocarcinoma)
  • Multiple fetal tissues (teratoma) or combination
34
Q

What 3 layers make up a teratoma?

A

Ectoderm, Endoderm, Mesoderm

35
Q

What is another name for a teratoma?

Is it more likely to be benign or malignant?

In what age group are malignant (immature) teratomas most likely found?

A
  • What is another name for a teratoma?
    • Dermoid cyst
  • Is it more likely to be benign or malignant?
    • Benign (mature)
  • In what age group are malignant (immature) teratomas most likely found?
    • < 18 years old
36
Q

What are the two types of sex cord derived tumors?

A

Can be estrogen (granulosa cells) or androgen secreting (sertoli cells)

37
Q

At what age do granulosa cell tumors occur?

What structures are present on histology?

A

Can occur at any age (but mostly postmenopausal)

  • Call Exner bodies (mimic follicles)
  • Mixture of lipid laden theca cells
38
Q

What are the stromal derived tumors?

A
  • Theca cell
  • Lutein cell
  • Leydig cell
39
Q

Which cancer often metastasizes to the ovaries?

A

Breast cancer

Reproductive System (35 decks)

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