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Repro / GU > SM_219b: Pathology of Ovary / Fallopian Tubes and Adnexal Mass > Flashcards

SM_219b: Pathology of Ovary / Fallopian Tubes and Adnexal Mass Flashcards

1
Q

Primary pathology is in the ___

A

Primary pathology is in the fallopian tube

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2
Q

Describe fallopian tube histology

A

Fallopian tube histology

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3
Q

Inflammatory disorders of fallopian tube are ____, ____, ____, and ____

A

Inflammatory disorders of fallopian tube are

  • Related to PID
  • Acute / suppurative salpingitis: due to Neisseria gonorrhoeae or other bacteria
  • Chronic salpingitis: follows resolution of acute salpingitis, risk of infertility and ectopic pregnancy
  • Hydrosalpinx: dilated tube lumen and flattened lining, usually result of acute / chronic salpingitis, filled with serous fluid
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4
Q

Acute salpingitis appears as ___ on histology

A

Acute salpingitis appears as distended plicae containing acute and chronic inflammatory cells on histology

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5
Q

Chronic salpingitis appears as ___ on histology

A

Chronic salpingitis appears as fused fibrotic plicae creating cyst-like spaces on histology

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6
Q

Hydrosalpinx appears as ____

A

Hydrosalpinx appears as dilated fallopian tube lumen

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7
Q

Risk factors for tubal ectopic pregnancy are ____, ____, and ____

A

Risk factors for tubal ectopic pregnancy are prior ectopic pregnancy, history of tubal sterilization, and history of PID / salpingitis

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8
Q

Ectopic pregnancy appears as ____, ____, and ____ on histology

A

Ectopic pregnancy appears as chorionic villi and fetail tissue within fallopian tube, implantation site in fallopian tube wall, and hematosalpinx on histology

  • Hematosalpinx: dilated fallopian tube containing blood
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9
Q

Paratubal cysts are ____

A

Paratubal cysts are benign cysts lined by different types of epithelium (e.g. mesothelium)

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10
Q

Hydatid of Morgagni is a ___

A

Hydatid of Morgagni is a cyst arising in fimbriated end from Mullerian duct remnants

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11
Q

Leading diangosis is ___

A

Leading diangosis is ectopic pregnancy

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12
Q

Treatment should be ___

A

Treatment should be bilateral salpingo-oophorectomy

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13
Q

Serous tubal intraepithelial carcinoma is ____ and ____

A

Serous tubal intraepithelial carcinoma is the probable origin of most high-grade serous ovarian carcinomas and arise from secretory tubal epithelial cells, usually the fimbriated end

  • Most often found in prophylactically removed specimens from high-risk patients
  • Mutation in p53 (same as corresponding invasive carcinoma)
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14
Q

Describe clinical implications of serous tubal intraepithelial carcinoma

A

Clinical implications of serous tubal intraepithelial carcinoma

  • Remove fallopian tubes along with ovaries in high-risk patients
  • Opportunistic salpingectomy in average-risk women
  • Carefully examine histology of fallopian tubes especially fimbriae
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15
Q

Describe pathology handling of fallopian tubes

A

Pathology handling of fallopian tubes

  • Always submit entire fimbriated end when present
  • High-risk patients: sectioning and extensively examining the fimbriated end (SEE-FIM)
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16
Q

Describe normal histology of the ovary

A

Normal histology of the ovary

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17
Q

Descrube oovarian follicles

A

Oovarian follicles

  • Primordial -> primary -> secondary / preantral -> tertiary / antral -> mature / Graafian
  • General structure: oocyte and surrounding supporting cells (granulosa cells, theca interna, theca externa)
  • After ovulation: corpus luteum (luteinization: accumulation of steroidogenic organelles - smooth ER, mitochondria)
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18
Q

Describe normal histology of the ovarian follicles

A

Normal histology of the ovarian follicles

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19
Q

Describe normal histology of the corpus luteum

A

Normal histology of the corpus luteum

20
Q

Non-neoplastic disorders of the ovary are ____, ____, and ____

A

Non-neoplastic disorders of the ovary are follicular / corpus luteal cysts, polcystic ovaries, and endometrial cysts / endometriosis

21
Q

Follicular / corpus luteal cysts are ____ that can ____ and cause ____

A

Follicular / corpus luteal cysts are dilated follicles filled with clear fluid usually < 2 cm that can rupture and cause peritonitis

22
Q

Polycystic ovarian syndrome causes ____

A

Polycystic ovarian syndrome causes anovulatory fertility

  • Increased androgens
  • Histologic features are non-specific but include numerous cystic and atretic follicles
23
Q

Describe the major categories of ovarian tumors

A

Major categories of ovarian tumors

  • Oocytes (germ cells): germ cell tumors
  • Supporting cells of the oocytes (sex cords) and ovarian stroma: sex cord-stromal tumors
  • Fallopian tube, endometriosis, other: epithelial tumors
  • Another origin: metastasis
24
Q

Describe the most common ovarian neoplasms

A

Ovarian neoplasms

  • Epithelial (65-70%): serous tumors (high-grade carcinoma), mucinous tumors, endometrioid carcinoma, clear cell carcinoma, Brenner tumor
  • Germ cell (15-20%): teratoma, dysgerminoma, yolk sac tumor
  • Sex cord-stromal (5-10%): fibroma / thecome, granulosa cell tumor, Sertoli-Leydig cell tumor
25
Q

Describe general categories of epithelial tumors

A

General categories of epithelial tumors

  • Histologic type: serous, mucinous, endometrioid, clear cell, Brenner
  • Malignant potential: benign, borderline (low), malignant
26
Q

Cystadenomas are ____

A

Cystadenomas are cystic neoplasm lined by benign epithelial cells

  • Most common histologic types: serous and mucinous
  • Mucinous epithelium: resembles endocervical mucinous cells or gastric / intestinal mucinous cells
27
Q

Describe mucinous cystadenoma

A

Mucinous cystadenoma

  • Multilocular cyst with smooth lining, can be very large (> 30 cm), contain mucoid / viscous fluid, usually unilateral
  • Multiloculated cysts containing mucin
28
Q

Describe borderline epithelial tumors

A

Borderline epithelial tumors

  • Atypical proliferative tumor, low malignant potential
  • Most common histologic types: serous, mucinous
  • Unusual features intermediate between benign and malignant tumors: extraovarian deposits (implants) in peritoneum or lymph nodes
29
Q

Compare type I and II epithelial carcinomas of the ovary

A

Type I and II epithelial carcinomas of the ovary

30
Q

Clear cell carcinoma is a ___

A

Clear cell carcinoma is a type I epithelial tumor of the ovary

(malignant)

31
Q

High-grade serous carcinoma is a ____ epithelial tumor of the ovary

A

High-grade serous carcinoma is a type II epithelial tumor of the ovary

(malignant)

32
Q

Describe high-grade serous carcinoma of ovary

A

High-grade serous carcinoma of ovary

  • Most common ovarian carcinoma
  • Aggressive neoplasm
  • Almost always presents at high stage (intraperitoneal spread, omental caking)
  • Most originate from STIC
  • Histology identical to uterine serous carcinoma
33
Q

Describe clear cell carcinoma of ovary

A

Clear cell carcinoma of ovary

  • Originates from endometriosis
  • High-grade tumor by definition (type I)
  • Classic histologic feature: hobnailing
34
Q

____ is characteristic histologic feature of clear cell carcinoma of ovary

A

Hobnailing is characteristic histologic feature of clear cell carcinoma of ovary

35
Q

Describe germ cell tumors of ovary

A

Germ cell tumors of ovary

  • Derived from pluripotent stem cells
  • Ovarian and testicular germ cell tumors can have same histologic types: different frequencies of each type, sometimes different behavior
36
Q

Teratoma can be ____ or ____

A

Teratoma can be mature or immature

37
Q

Describe mature teratoma

A

Mature teratoma

  • Most common ovarian germ cell tumor
  • Almost always cystic
  • Derivatives from multiple germ layers
  • Benign
38
Q

Describe immature teratoma

A

Immature teratoma

  • At least focal immature or embryonal tissue
  • Malignant tumor: can grow rapidly, metastasize, and recur
39
Q

Yolk sac tumor is a ____ that produces ____

A

Yolk sac tumor is a malignant germ cell tumor that produces alpha-fetoprotein

40
Q

____ is pathognomonic finding of yolk sac tumor

A

Schiller-Duval body is pathognomonic finding of yolk sac tumor

41
Q

Sex cord-stromal tumors are derived from ____

A

Sex cord-stromal tumors are derived from ovarian stroma / sex cords

  • Can be purely stromal, purely sex cord, or mix of both
42
Q

Describe fibrothecoma

A

Fibrothecoma

  • Benign tumor
  • Solid, well-circumscribed
  • Composed of fibroblasts (fibroma) with collagenous stroma and theca cells (thecoma) which are plump spindle cells containing lipid
  • Occasionally fibroma is associated with Meigs syndrome: ovarian tumor + ascites + hydrothorax
43
Q

Granulosa cell tumor has types of ____ and ____

A

Granulosa cell tumor has types of adult and juvenile

  • Adult type: usually postmenopausal patients
  • Juvenile type: young patients
  • Adult type much more common
44
Q

Adult granulosa cell tumor classic feature is ___

A

Adult granulosa cell tumor classic feature is Call-Exner body

  • Considered low malignant potential: can metastasize and recur
  • Produce estrogen: can be associated with endometrial hyperplasia
45
Q

Most common primary sites of metastatic ovarian tumors are ____, ____, and ____

A

Most common primary sites of metastatic ovarian tumors are gynecologic, GI tract, and breast

46
Q

This is a ____ originating from the ____

A

This is a high-grade serous carcinoma originating from the fallopian tube

47
Q

This is a ___

A

This is a cystadenoma

Repro / GU (46 decks)

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