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S3B3 Pathology > Uterine Tube & Ovaries > Flashcards

Uterine Tube & Ovaries Flashcards

1
Q

Identify the 4 components of the uterine tube.

A
  • Isthmus
    • narrowest area
    • attaches to the uterus
  • Ampulla
    • long central portion
  • Infundibulum
    • Wide, outermost part
  • Fimbriated End (fingers)
    • catches the oocyte at ovulation
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2
Q

The provided cross section is from what section of the uterine tube?

A

ampulla

prominent tubal plica

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3
Q

The provided cross section is from what section of the uterine tube?

A

Fimbria

where plicae are suspended from the infundibulum in a frond-like appearance

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4
Q

The provided cross section is from what section of the uterine tube?

A

Isthmus

contains both an inner longitudinal & outer circular muscle layer

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5
Q

What condition is shown in the provided image?

A

Acute salpingitis

  • Dilated, inflamed uterine tube with pus
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6
Q

The provided histological slide is a sample of a uterine tube with what pathology?

A

Acute Infectious Salpingitis

  • lots of neutrophils (both in epithelium & stroma)
  • pus
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7
Q

What condition is depicted in the provided image of the gross sample?

A

Pyosalpinx

  • dilated uterine tube filled with pus
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8
Q

What are the possible outcomes that can result after a person develops pyosalpinx?

A

can progress to an abscess (walled off with fibrous wall)

can resolve causing scarring w/ loss of fimbria (possible closing of tube)

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9
Q

What condition is shown in the provided image?

A

Chronic Infectious Salpingitis

  • acute salpingitis that has been incompletely treated or not treated at all
  • or, can be caused by less virulent organisms
  • lymphocytes, plasma cells & variable numbers of neutrophils
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10
Q

Chronic infectious salpingitis can lead to what serious complication?

A

pelvic inflammatory disease

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11
Q

The provide microscopic slide is an sample from what pathology?

A

Hydrosalpinx

scarred tube w/ variable loss of plicae with relatively smooth mucosal surface without folds

lots of fibrosis in the wall & it may be cystically dilated

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12
Q

What condition is shown in the provided image?

A

Hydrosalpinx

uterine tube dilation that is smooth both on the inside & outside

due to blockage of uterine tube by inflammation & scarring

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13
Q

What pathology is shown in the provided image?

A

Ectopic Pregnancy

ruptured tubal pregnancy with extensive hemorrhage - tiny embryo (white) is present in the center of the clot

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14
Q

What is an ectopic pregnancy?

A

When implantation occurs at a location other than the uterine cavity

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15
Q

What are the consequences of an ectopic pregnancy?

A
  • fetus will not get vey large b/c not much room nor is it a nurturing environment
  • can cause a life-threatening hemorrhage
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16
Q

Describe the components of this histological slide of an ectopic pregnancy.

A
  • lower left: chorionic villi
  • middle: rupture (hemorrhage)
  • right: tubal plicae
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17
Q

What structures are shown in the provided image?

A

Normal ovaries & uterine tubes of an individual of reproductive age

  • sometimes will see cysts, little areas of hemorrhage (ruptured corpus luteum) – perfectly normal
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18
Q

The provided histological slide was provided from what structure?

A

normal ovary

C: ovarian cortex

M: medulla

H: hilus

CL: corpus luteum

CF: cystic follicle

LF: leutinized follicle

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19
Q

What condition produced the sample shown in the provided image?

A

Tubo-Ovarian (Adnexal) Torsion

dusky, dark red appearance - hemorrhagic cystic & solid cut surface

  • solid white arrow: ovary
  • open white arrow: uterine tube
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20
Q

Which blood supply is more affected by adnexal torsion? Why?

A

venous blood leaving the structure because it has thinner walls & is more easily compressible - leads to combination of congestion that will eventually impede the inflow of blood & ischemia

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21
Q

What is the difference between a follicular cyst & a cystic follicle?

A

size (basically)

thin-walled cyst filled with clear cystic fluid

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22
Q

What histology would you expect to see in a follicular cyst?

A

normal

single layer of granulosa cells resting on a thick theca layer

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23
Q

What type of pathology is shown in the provided image?

A

Corpus Luteum Cyst

  • cyst with smooth yellow lining & hemorrhagic material in the lumen
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24
Q

The provided histological slide is an example of what kind of cyst?

A

Corpus Luteum Cyst

  • Pink corpus luteum appearance (though much larger)
  • central hemorrhage (red)
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25
Q

The provided image is an example of what type of pathology?

A

Endometriotic Cyst

“chocolate” cyst

old, clotted blood is dark brown

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26
Q

What is the most common presentation of an endometriotic cyst? It can cause what potential complication?

A

pelvic pain

infertility - no increased risk of malignancy

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27
Q

The provided images are example of what condition?

A

Polycystic ovaries

  • Left:
    • large ovaries with many superficial cysts
    • central stroma is homogeneous (lacking corpora lutea)
  • Right:
    • multiple superficial cysts
    • thickened cortex
    • absent corpora lutea or corpora albicantia
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27
Q

The provided images are example of what condition?

A

Polycystic ovaries

  • Left:
    • large ovaries with many superficial cysts
    • central stroma is homogeneous (lacking corpora lutea)
  • Right:
    • multiple superficial cysts
    • thickened cortex
    • absent corpora lutea or corpora albicantia
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28
Q

What is Stein Leventhal syndrome?

A

also - Polycystic Ovarian Syndrome (PCOS)

characteristic of elevated androgens and infrequent/absent ovulation (infertility) – often leading to ovaries with multiple cysts, insulin resistance (Type II Diabetes)

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29
Q

Patients with PCOS have an increased risk of what serious condition?

A

endometrial carcinoma

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29
Q

Patients with PCOS have an increased risk of what serious condition?

A

endometrial carcinoma

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30
Q

Describe the most affected ages for benign, borderline & malignant tumors of the ovaries.

A
  • Benign
    • young, mainly 20-45
  • Borderline
    • slightly older
  • Malignant
    • older women, mainly 45-65
31
Q

What type of malignant tumor is most commonly found on the ovaries? Is it a good prognosis?

A

5 leading cause of cancer deaths in women

90% are carcinomas

80% have spread beyond ovaries upon diagnosis

32
Q

What factors increase the risk of ovarian cancer?

A
  • BRCA1 or BRCA2
  • childhood gonadal dysgenesis
  • clomiphene use
  • family history
  • nullparity (b/c increased number of menstrual cycles)
  • hereditary nonpolyposis colin cancer (HNPCC, Lynch syndrome)
33
Q

What are factors that reduce the risk of developing ovarian cancer

A
  • history of oral contraceptive use
  • late menarche or early menopause
  • multiparity
  • prophylactic oophorectomy
  • first pregnancy before 25
  • tubal ligation
34
Q

Ovarian tumors can arise from what 4 precursor tissues?

A
  1. surface epithelial-stroma tumors
  2. germ cell tumors
  3. sex cord-stromal tumors
  4. metastatic carcinomas
35
Q

What is the term for tumors present with glands and cysts?

A

cystadenoma

cystadenocarcinoma

36
Q

What is the term for tumors present with glands and fibrotic stroma?

A

adenofibroma

adenocarcinofibroma

37
Q

What is the term for tumors present with glands,cystic areas & fibrotic stroma?

A

cystadenofibroma

cystadenocarcinofibroma

38
Q

What is the difference in pathogenesis of ovarian epithelial tumors: Type I and Type II

A
  • Type I:
    • progress from benign to borderline tumors
    • may then progress to low-grade carcinoma
  • Type II:
    • arise from inclusion cysts/fallopian tube epithelium via intraepithelial precursors
    • (serous tubal intraepithelial carcinomas, STIC)
39
Q

The provided histological slide is an example of what type of ovarian tumor?

A

Serous tumor

40
Q

Are serous tumors usually unilateral or bilateral?

Where are the most common locations that serous carcinomas spread?

Prognosis?

A

bilateral is common

spread to peritoneal surfaces & omentum

high grade carcinomas usually have poor prognosis

41
Q

Serous carcinomas ar commonly associated with what other symptom?

A

ascites

42
Q

What type of ovarian tumor is shown in the provided image?

A

serous cystadenoma

smooth external & internal surfaces

characteristically contain straw-colored fluid & have a minimal stormal component

may have thick walls w/ internal folds when collapsed

43
Q

Are serous cysadenoma usually bilateral or unilateral?

A

unilateral

44
Q

Serous cystadenomas are lined by what type of cells?

A

can be columnar, ciliated, or flattened cells

diagnostic cell type: ciliated mullerian epithelium

45
Q

The provided histological slide is a sample form what type of ovarian tumor?

A

serous cystadenoma

single layer of bland-looking epithelium lining cells

46
Q

The provided image is an example of what type of ovarian tumor?

A

Serous Borderline Tumor

cyst cavity lined by delicate papillary tumor growth

47
Q

The provided histological sample is from what type of ovarian tumor?

A

Serous Borderline Tumor

increased architectural complexity and epithelial cell stratification

stratification of epithelial cells

still NO invasion

47
Q

The provided histological sample is from what type of ovarian tumor?

A

Serous Borderline Tumor

increased architectural complexity and epithelial cell stratification

stratification of epithelial cells

still NO invasion

48
Q

What type of ovarian tumor is shown in the provided image?

A

Serous Carcinoma (Adenocarcinoma)

gross appearance - cyst opened to show bulky tumor

49
Q

The provided histological sample is from what type of ovarian tumor?

A

Serous Carcinoma (adenocarcinmoa)

stromal invasion is circled

complex capillary structures w/ more atypical cells

50
Q

Identify which of the following pictures are examples of serous cystadenoma, borderline serous tumor, low-grade “micropapillary” serous carcinoma, and high-grade serous carcinoma

A
51
Q

What percent of serous tumors of the ovaries are malignant?

What about mucinous tumors of the ovaries?

A

serous: 25%
mucinous: 10%

52
Q

Are mucinous tumors more likely to be unilateral or bilateral?

A

unilateral - only 5% are bilateral

53
Q

What mutation is frequently seen in mucinous tumors of the ovary?

A

KRAS protooncogene mutations

54
Q

What type of ovarian tumor is shown in the provided image?

A

mucinous cystadenoma

multicystic mass, delicate septa & glistening mucin within the cysts

55
Q

The provided histological sample is likely from what type of ovarian tumor?

A

mucinous cystadenoma

columnar cell lining the cysts, similar to endocervical cells

benign cells with basally placed nucleus, producing a lot of mucin

(can also be lined by epithelial cells that look like foveolar cells of the stomach/intestine)

56
Q

What type of ovarian tumor is shown in the provided image?

A

mucinous borderline tumor - endocervical type

unilocular cyst containing variable number of soft, delicate papillary excrescences

tend to have more solid areas

typically filled with gelatinous contents

57
Q

The provided histological sample is likely from what type of ovarian tumor?

A

mucinous borderline tumor - endocervical type

hierarchical branching of papillae is characteristic

more complex architecture than totally benign lesions

58
Q

What type of ovarian tumor is shown in the provided image?

A

Mucinous Carcinoma (adenocarcinoma)

solid and cystic mass containing soft, fleshy nodules & mucoid contents

can also get invasion of the stroma

a lot of areas of solid & some cystic areas

59
Q

The provided histological sample is likely from what type of ovarian tumor?

A

mucinous carcinoma (adenocarcinoma)

confluent growth of closely packed complex gland with little intervening stroma

papillary architecture with more nuclear atypia than borderline tumors (bigger nuclei, more pleomorphism, chaotic/disorderly architecture)

60
Q

What condition is depicted by the provided samples?

A

Endometrioid Adenocarcinoma

can look like endometriosis – difference is the back to back glands

  • Gross
    • cystic tumor with solid areas & cysts the contain hemorrhagic, chocolate-colored fluid
    • tumor surface is usually smooth
  • Microscopic
    • pattern of back-to-back glands w/ little stroma
    • labyrinthine outline (chaotic archetecture) and smooth luminal contours
61
Q

What type of ovarian tumor is shown in the provided image?

A

Transitional Cell “Brenner” Tumors

solid, tan, well-circumscribed

62
Q

The provided histological sample is likely from what type of ovarian tumor?

A

Transitional Cell “Brenner” Tumors

characteristic epithelial nests within the ovarian stroma

62
Q

The provided histological sample is likely from what type of ovarian tumor?

A

Transitional Cell “Brenner” Tumors

characteristic epithelial nests within the ovarian stroma

63
Q

What type of ovarian tumor is shown in the provided image?

A

Benign (mature) cystic teratoma

inside of the cysts may show hair, teeth, & a variety of different tissues microscopically

64
Q

What type of ovarian tumor is shown in the provided image?

A

Monodermal (specialized) teratomas

tan to yellow areas (carcinoid) juxtaposed to “beefy” red areas with secondary cystic change (think goiter)

65
Q

The provided histological slide is an example of what type of pathology? It is most commonly seen in what demographic?

A

Immature cystic teratoma

primitive neuroepithelium is present (dark blue cells) & may contain immature cartilage, bone / other elements

young women & pre-adolescent girls

66
Q

What ovarian tumor is shown in the provided image?

A

Dysgerminoma

lobulated appearance with solid, soft, and tan cut surface

67
Q

The provided histological slide is from what type of ovarian tumor?

A

Dysgerminoma

alveolar growth composed of irregular tumor cell nests separated by delicate fibrous septa (that contain lymphocytes)

68
Q

The provided histological slide is from what type of ovarian tumor?

A

Yolk Sac (Endodermal Sinus) Tumor

  • Left
    • lace-like network of medium-sized cells tha tmay contain Schiller-Duvall bodies
  • Right
    • Schiller-Duval body (central blood vessel surrounded by layers of tumor cells)
69
Q

Yolk Sac tumors are positive for what protein?

A

alpha-fetoprotein (AFP) +

70
Q

What is Pseudomyxoma peritonei?

A

the entire peritoneal cavity is occupied by innumerable mucinous nodules

71
Q

The provided histological slide is characteristic for what type of pathology?

A

Pseudomyxoma peritonei

clusters of well-differentiated mucin-producing glands floating in a sea of mucin

72
Q

What is the name for bilateral ovarian involvement of metastatic tumors?

A

Krunkenberg Tumor

73
Q

The provided histological slide is a sample from what type of ovarian tumor?

A

Embryonal Carcinoma

  • Sheets of undifferentiated cells & primitive glandular structures
  • large, pleomorphic cells with hyperchromatic nuclei & prominent nucleoli
  • frequent mitoses
  • almost always occur as part of a mixed germ cell tumor
74
Q

The provided histological slide is a sample from what type of ovarian tumor? It is composed of what 2 cell types?

A

choriocarcinoma

  • growth pattern in cords / sheet of cells
  • Cell types
    1. Syncytiotrophoblasts
    2. Cytotrophoblasts
75
Q

What are Syncytiotrophoblasts? What are Cytotrophoblasts? They are found in what type of tumor?

A

Choriocarcinoma

  • Syncytiotrophoblasts
    • large, multinucleated cells with cytoplasm that contains HCG
  • Cytotrophoblasts
    • regular / polygonal cells with distinct borders & clear cytoplasm
    • each with single, fairly uniform nucleus

S3B3 Pathology (6 decks)

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