Reproductive Pathology (Benign Female)

Question 1

Follicular cyst

*May cause endometrial hyperplasia…how?

Answer 1

Distention of UNRUPTURED GRAAFIAN FOLLICLE

• -Fluid filled structure in ovary within which an ovum develops before ovulation
• -May be surrounded by granulosa cells which secrete ESTROGEN —> endometrial hyperplasia

Question 2

Corpus luteum cyst

Answer 2

Hemorrhage into PERSISTENT CORPUS LUTEUM

• -Commonly regresses spontaneously
• -May rupture and cause peritonitis and mimic endometriosis

Question 3

What is the difference between a dermoid cyst and a mature cystic teratoma

Answer 3

• -Not much really
• -Can contain elements from 3 germ layers
• -May have teeth, hair, fat, bone or cartilage
• -MAJOR difference is that mature cystic teratomas may contain FUNCTIONAL THYROID TISSUE and present as HYPERTHYROIDISM —-> “STRUMA OVARII”

Question 4

Ovarian neoplasms are common in which age group

Answer 4

Women > 55yo

Question 5

Common genetic conditions associated with ovarian neoplasms (4)…the fourth is a bit odd

Answer 5

BRCA-1
BRCA-2
HNPCC (Lynch –> colon, ovarian, and endometrial tumors)
*Family hx

Question 6

Best marker to monitor progression of ovarian neoplasms?

Answer 6

CA-125 levels…not good for screening

Question 7

Common symptoms of ovarian neoplasms

Answer 7

Ascites
Abd distention or pain
Nausea
Early satiety
Vaginal bleeding
Urinary symptoms

Question 8

Serous cystadenoma

Answer 8

Thin walled, uni- or multilocular
Lined with fallopian epithelium (secretory columnar)
**Literally filled with serous fluid
**Benign

Question 9

Mucinous cystadenoma

Answer 9

Similar to serous cystadenoma

• *Multiloculated and large. Lined with mucus-secreting epithelium
• *Benign

Question 10

Brenner Tumor

• -histology is similar to which organ?
• -gross appearance
• -characteristic appearance on H&E stain

Answer 10

• *Looks like bladder….contains transitional epithelium
• -Solid tumor
• -Pale yellow-tan in color and appears encapsulated
• • “Coffee bean” nuclei on H&E stain
• *benign

Question 11

Fibromas
what do they look like (microscopically)
presenting symptom

Answer 11

Bundles of spindle-shaped fibroblasts

• *Pulling sensation in groin
• *benign

Question 12

Fibromas are associated with what syndrome?

Answer 12

MEIGS SYNDROME

OVARIAN Fibromas, ascites, and hydrothorax (pleural effusion)

Question 13

Thecoma

• *which patient population
• *why is this a problem

Answer 13

Similar to granulosa cell tumor because it PRODUCES ESTROGEN

• *Usually presents as ABNORMAL UTERINE BLEEDING in POSTMENOPAUSAL WOMEN
• *technically benign but 20% have endometrial carcinoma