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Patho 3 Shea > Tumors / Cysts > Flashcards

Tumors / Cysts Flashcards

1
Q

Which tumor?

  • Originate from specialized ovarian stromal cells
  • 5% of ovarian tumors
  • Has 3 variants
A

Sex Cord Stromal Tumors

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2
Q

What are the 3 Sex Cord Stromal Tumor Variants

A
  • Thecomas
  • Granulosa Cell Tumors
  • Sertoli-Leydig Cell Tumors
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3
Q

Which tumor?

  • Solid tumor
  • Secretes estrogens
  • Always benign
  • Cause menstrual irregularities
  • Causes endometrial hyperplasia
A

Thecomas

(Sex Cord Stromal Tumors)

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4
Q

Marshmellow man w/ detached penis beside him

A

Thecoma of Ovary

(Sex Cord Stromal Tumors)

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5
Q

Which tumor?

  • Solid tumor
  • Cells resemble granulosa cells of ovarian follicles
  • Produce estrogens / menstrual irregularities
  • Small ones are benign
  • Large ones may be malignant
  • Can cause precocious puberty in young girls
  • Can lead to breast / endometrial cancer in older women
A

Granulosa Cell Tumors

(Sex Cord Stromal Tumors)

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6
Q

“Fish w/ a bloody side fin”

A

Granulosa Cell Tumor

(Sex Cord Stromal Tumors)

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7
Q
  • Solid tumors
  • Hormonally active cells which secrete Androgens –> cause virilization (deep voice, facial hair, male pattern baldness, hairy chest w/ hypertrophy of clitoris)
  • May be benign or malignant
A

Sertoli-Leydig Cell Tumors

(Sex Cord Stromal Tumors)

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8
Q

Tomato w/ sun spots

A

Sertoli-Leydig Cell Tumor

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9
Q

Which tumor?

  • Originate most often from carcinomas of endometrium and breast
  • Have estrogen receptors (metastasize to ovaries)
  • Tumors of GI tract metastasize to ovaries
  • Most common is stomach carcinomas (produce bi enlargement of ovaries-Krukenberg tumors)
A

Metastatic Ovarian Tuors

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10
Q

Metastasis of GI tract to ovary

A

Krukenberg tumors

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11
Q

fortune cookie

A

Krukenberg Tumor

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12
Q
  • Implantation of fetus in ANY other site other than the normal uterine location
  • 1/150 pregnancies
  • Chronic Salpingitis (adhesions) leads to this
  • Peritubal adhesions from endometriosis, previous surgeries, and leiomyomas
  • *Chronic complication of PID*
A

Ectopic Pregnancy

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13
Q

3 most common areas of ectopic

A
  • fallopian tubes (95%)
  • ovary
  • Abdominal Cavity
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14
Q

How/why do ectopic pregnancies occur?

A
  • Intratubal adhesions forms barrier to normal passage of zygote (so the zygote implants at site of obstruction)
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15
Q
  • The entire fertile zygote undergoes its normal development w/ formation of placental tissue & amniotic sac
  • Placenta is poorly attached to wall of tube
  • This all leads to what 3 things?
A
  • Weakening of tube
  • Risk of rupture
  • Risk of intraperitoneal hemorrhage
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16
Q

W/ ectopic pregnancy, when does rupture usually occur?

A

2-6 weeks after pregnancy

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17
Q

Describe the fallopian tube

A

Dilated

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18
Q
  • Severe abdominal pain
  • Possibility of shock (which type)?
  • Signs/sxs of acute abdomen
A

Ruptured Ectopic Pregnancy

-Hypovolemic shock (Hemorrhagic Shock)

19
Q

Ectopic Pregnancy

Are pregnancy tests positive or negative?

A

Positive

20
Q

What procedure could you perform to detect a ruptured ectopic?

A

Aspiration of fresh blood from pouch of Douglas (posterior fornix)

21
Q

What is helpful in dx of Ectopic Pregnancy?

A

Endometrial biopsy

22
Q

How is dx of ectopic pregnancy made?

A

US of fallopian tube showing dilation

23
Q
  • Absence of ____ ____ is consistent w/ ectopic pregnancy
  • What will biopsy show?
  • US will show what?
A
  • Chorionic villi
  • Decidual reaction of endometrium
  • Dilation of fallopian tube
24
Q
  • Rupture of ectopic is medical emergency
  • How many die before hemorrhage can be controlled?
A

1/400

25
Q
  • Disease which involves trophoblastic epithelium and includes a spectrum of proliferative lesions
A

Gestational Trophoblastic Disease

26
Q

3 types of Gestational Trophoblastic Disease (GTD)

A
  • Benign: Hydatidiform
  • Limited proliferation: trophoblast
  • Highly malignant: Choriocarcinoma
27
Q
  • Has no fetal parts
  • Only contains placental tissue inside the uterus w/ “snow storm patter” on US
  • No heart, no baby, ONLY grapes of chorionic villi
A

Gestational Trophoblastic Disease (GTD)

28
Q
  • Placental abnormality marked by trophoblastic proliferation & hydropic degeneration of chorionic villi
A

Hydatidiform Mole

(Gestational Trophoblastic Disease) - benign

29
Q
  • Most common form of Hydatidiform Mole
  • Fetus cannot be identified in amniotic sac
  • Results from abnormal fertilization (all chromosomes are paternal due to loss of maternal chromosomes from zygote at time of fertilization)
  • **Duplication of paternal haploid**
A

Complete Mole

(Gestational Trophoblastic Disease)

30
Q

Alien baby

A

Complete Hydatidiform Mole

(Gestational Trophoblastic Disease)

31
Q
A

Swollen Hydropic Villi

(of Hydatidiform Mole)

(Gestational Trophoblastic Disease)

32
Q

Complete Hydatidiform Mole (of GTD)

  • Has no fetal parts/no embryo development, bc it has no maternal chromosomes, so the placenta undergoes what?
  • Paternal 23, X set of chromosomes reduplicates = 46 (this is called what?)
A
  • Hydropic degeneration
  • Androgenesis
33
Q
  • Evolves from oocytes fertilized w/ 2 spermatozoa.
  • How many chromosomes?
  • __ sets from mom
  • ___ sets from dad
A

Incomplete Hydatidiform Mole (GTD)

  • 69
  • 1 from mom
  • 2 from dad
34
Q
  • Lethal
  • But, embryo doesn’t die immediately
  • Parts of embryo found encased among hydropically altered placental villi & normal placental tissue
A

Incomplete Hyatidiform Mole (GTD)

35
Q

In the US, Hydatidiform Moles of GTD are rare (1/2000)

  • What is dx based on?
A
  • enlarged uterus for corresponding / calculated duration of pregnancy
  • No signs of fetal movement
36
Q

Best method for dx Hydatidiform Mole (GTD)?

A

US will detect snow-storm patter w/ no fetal heart beat or movement

37
Q
  • W/ Hydatidiform Mole, high serum and urine levels of ____ are typically found.
  • What is the malignant tumor called?
  • Grossly, placenta is transformed into ______.
A
  • HCG
  • Chorio
  • numerous grape-like clear vesciles filled w/ fluid / covered w/ hyperplastic trophoblastic epithelium
38
Q
  • Malignant tumors composed of trophoblastic cells
  • 50% arise from preexisting complete mole
  • 25% arise from placental tissue retained after abortion
  • 25% arise from normal placenta after completion of normal pregnancy
A

Choriocarcinoma

39
Q

Why is it important to remove all parts of abnormal placenta of Hydatidiform Mole?

A

Remaining trophoblastic cells could give rise to malignancy (chorio)

40
Q
  • Highly invasive tumors
  • The tumor secretes ___ which is a good marker for the disease and monitors tumor recurrence after chemotherapy
A

Choriocarcinoma

HCG

41
Q
  • Forms bulky hemorrhagic nodules in placental bed
  • Invades through wall of uterus & often invades through wall of uterus
  • Often implants in vagina
A

Choriocarcinoma

42
Q

By invading ____, metastasizes to lung, liver, and brain.

A

veins

43
Q

Tumor responds well to chemo w/ _____ and cure rates of 80-100% have been achieved (but only in those w/o metastases.

A

Methotrexate

(Choriocarcinoma)

44
Q

C shaped

A

Choriocarcinoma

Patho 3 Shea (19 decks)

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