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Emma Repro > The Ovary > Flashcards

The Ovary Flashcards

1
Q

types of ovarian cysts

A
  • epithelial (serous, mucinous)

- germ cell (dermoid)

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2
Q

ovarian cysts

A
  • unilateral lower quadrant pain
  • achy/crampy pain
  • acute/sharp pain
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3
Q

most common cysts found on ovary

A

functional cysts

  • follicular
  • corpus luteal
  • hemorrhagic corpus luteum
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4
Q

SEVERE unilateral lower quadrant pain

A
  • ruptured ovarian cyst
  • ovarian torsion
  • ectopic pregnancy
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5
Q

when to consider rx for ovarian cysts

A

> 10cm, persistent, symptomatic, concerning features

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6
Q

serous tubal intraepithelial carcinoma

A

precursor lesion for a majority of high-grade pelvic cancers

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7
Q

ovarian surface epithelium hypothesis

A

chronic ovulation –> inflammation/repair from endometriosis

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8
Q

ovarian cancer risk fx

A
  • infertility, nulliparity
  • early menarche, late menopause
  • hereditary (BRCA, Lynch)
  • envio (high fat, others)
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9
Q

ovarian cancer: protective factors

A
  • tubal ligation and salpingectomy
  • pregnancy
  • OCPs
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10
Q

ovarian cancer can present with which abnormalities of the abd

A

ascites

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11
Q

ovarian cancer can present with which abnormalities of the pelvis

A

pelvic mass

cul-de-sac modularity

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12
Q

ovarian tumor marker

A

CA-125

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13
Q

CA 125 screening recommendation

A

not recommended for screening among the general population

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14
Q

ovarian cancer spread

A
  • direct extension to pelvic and abd viscera

- lymphatic dissemination

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15
Q

ovarian cancer tx

A
  • surgery/debulking

- chemo (platinum-based)

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16
Q

ovarian staging

A

I-ovaries only
II-pelvic extension only
III-extrapelvic extension
IV-intraparencymal liver mets, pleural effusion

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17
Q

ovarian cancer prognosis

A

age

stage

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18
Q

__% of germ cell ovarian cancer is benign

A

97%

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19
Q

germ cell tumors are more common in

A

young women

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20
Q

types of ovarian germ cell cancers

A
  • immature teratoma
  • dysgerminoma
  • endodermal sinus tumor (yolk sac)
  • choriocarcinoma
  • embryonal carcinoma
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21
Q

HCG

A

choriocarcinoma

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22
Q

AFP

A

yolk sac tumors

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23
Q

LDH

A

dysgerminoma

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24
Q

CA-125

A

dysgerminoma
immature teratomas
yolk sac tumors
mixed tumors

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25
Q

germ cell ovarian cancer tx

A

-feritlity-sparing surgery usually an option

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26
Q

female sex cord-stomal ovarian cancer

A

stromal and granulosa cell

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27
Q

male sex cord-stomal ovarian cancer

A

sertoli and leydig cells

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28
Q

follicular cysts

A
  • repro age group
  • incidental findings or present with menstrual or hormonal abnormalities
  • rarely ruptures
  • lined by follicle and theca cells
  • most regress spontaneously
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29
Q

corpus lute cyst

A
  • repro group
  • delayed resolution of physio corpus luteum
  • -menstrual irregularities
  • cyst wall composed of luteinized granulosa cells
30
Q

thick, yellow wall

A

luteinized granulosa and theca cells

31
Q

endometriosis cyst

A
  • ovary
  • thick, altered blood (CHOCOLATE CYST)
  • cyst wall=endometrial-type glands, stroma, hemorrhage/hemosiderin
32
Q

ovarian tumors, malignant or benign

A

most are benign

33
Q

which tumors of the ovary represent the highest total % and highest total malignant %

A

epithelial

  • serous
  • mucinous
  • endometrioid
  • clear cell
  • transitional cell/Brenner
34
Q

tubal type epithelium

A

serous epithelial tumor

35
Q

endocervical type epithelium

A

mucinous epithelial tumor

36
Q

endometrioid type epithelium

A

endometrioid epithelial tumor

37
Q

secretory type endometrial epithelium

A

clear cell tumors

38
Q

transitional type epithelium

A

transitional cell/Brenner

39
Q

surface epithelial tumors show morphology similar to

A

Fallopian tube/endometrium/cervix

recapitulate cell types formed by Mullerian duct

40
Q

cystadenoma

A
  • unilocular cysts
  • lined by tubal type epithelium
  • contain thin, clear serous fluid
41
Q

benign serous cystadenoma histo

A

benign tubal-type epithelium

42
Q

borderline serous cystadenoma histo

A

more papillary configuration, no stromal invasion

43
Q

malignant serous cystadenoma histo

A

complex papillary growth with cytological atypia and stromal invasion

44
Q

malignant serous cystadenoma

A

derived from serous tubal intraepithelial carcinoma (STIC) cells of the Fallopian tube, which drop off onto the ovary

*risk reducing salpingectomy may reduce the incidence of this tumor in high risk patients

malignant serous tumors may be cystic or solid

papillary growth

45
Q

psammoma bodies

A

calcified spherules found in any papillary tumor

common in serous carcinoma

46
Q

most ovarian gerrm cell tumors are

A

mature cystic teratomas (dermoid cysts) - benign, peak 20-30 y/o

47
Q

dermoid cyst

A

mature teratoma

one of the most comm ovarian tumors

48
Q

most common immature element of immature teratoma

A

neuroepithelium

49
Q

most comm malignant germ cell tumor

A

dysgerminoma

50
Q

tumor similar to the seminoma of the testis and germinoma of the CNS/mediastinum

A

dysgerminoma

51
Q

dysgerminoma prognosis

A

excellent, radiosensitive and usu low stage

52
Q

dysgerminoma histo

A 
undifferentiated germ cells
nests of lg cells w/ clear cytoplasm
central nuclei
"fried egg" 
glycogen/lymphocytes
53
Q

the least differentiated germ cell tumor

A

embryonal carcinoma

54
Q

embryonal carcinoma

A

highly malignant tumor

potential for differentiating towards endodermal sinus tumors, choriocarcinomas or teratomas

55
Q

yolk sac tumor

A

aka endodermal sinus tumor

highly malignant tumor w/ differentiation towards yolk sac structures

Schiller-Duval body

AFP

56
Q

Schiller-Duval body

A

ovarian yolk sac tumor

glomeruloid body

57
Q

AFP

A

prod by ovarian yolk sac tumor

used for dx and therapeutic monitoring

58
Q

choriocarcinoma

A
  • a highly malignant tumor, mets widely via bloodstream
  • 2 types: gestational, ovarian
  • malignant CYTOTROPHOBLAST and SYNCYTIOTROPHOBLAST
  • prod hCG
59
Q

most common of the stromal tumors

A

fibroma

60
Q

fibroma

A
  • most comm stromal tumor
  • NON-estrogenic
  • perimenopausal age group
  • mass or ascites, esp in larger tumors
  • Meig’s syndrome
  • benign, look like fibroids, composed of fibroblasts
61
Q

Meig’s syndorme

A

ovarian tumor
ascites
pleural effusion
rare presentation of fibroma

62
Q

Thecoma

A
  • benign, post menopausal

- prod ESTROGEN

63
Q

complications of thecoma

A

estrogenic side effects

  • abnml uterine bleeding
  • endometrial hyperplasia and carcinoma
  • breast changes
64
Q

theca appearance

A

yellowish color due to stromal theca cell accumulation of lipid

65
Q

granulosa cell tumor

A
  • malignant
  • occur mainly in postmenopausal patients
  • fxnl, producing estrogen
  • typical grooved nucleus (“coffee bean”)
  • small rosettes, recapitulate immature follicles (Call-exner bodies)
66
Q

Call-exner bodies

A

granulosa cell tumor

67
Q

sertoli stromal tumors

A
  • RARE
  • young women
  • usu benign
  • fxnl, prod androgen
68
Q

ovarian malignant tumors that are metastatic from other sites are commonly from

A
  • other sites in female genital tract (ENDOMETRIUM)
  • breast
  • lg intestine
  • stomach
69
Q

Krukenberg tumor

A

bilateral metastatic gastric signet cell carcinoma

classic metastatic tumor of the ovaries

70
Q

signet ring cells stain with

A

mucicarmine for mucin

Emma Repro (23 decks)

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