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Human Reproduction > Week 4: Ovary > Flashcards

Week 4: Ovary Flashcards

1
Q

Review of ovarian embryological origins

A
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2
Q

Gross histology Ovarian

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3
Q

Gross histology Ovaries

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4
Q

Ovarian stroma histology

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5
Q

Ovarian follicle histology

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6
Q

Corpus luteum histology

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7
Q

Corpus albicans histology

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8
Q

Ovarian follicular cysts

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9
Q

Follicular cyst histology

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10
Q

Follicular cyst histology

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11
Q

Polycystic Ovarian Syndrome

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12
Q

Polycystic ovary hstology

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13
Q

Polycystic ovary hstology

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14
Q

Origins of ovarian tumors

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15
Q

Ovary histology

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16
Q

Ovarian epithelial neoplasms

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17
Q

Ovarian epithelial neoplasms

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18
Q

Ovarian histology cartoon

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19
Q

Cortical inclusion cyst (surface epithelium)

A
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20
Q

Ovarian epithelial cystic neoplasms cell types

5 listed

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21
Q

Ovarian epithelial cystic neoplasms biologic grades

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22
Q

Serous tumors of the ovary

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23
Q

Serous tumors of the ovary

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24
Q

Serous tumors of the ovary gross histology

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25
Q

Serous tumors of the ovary gross histology

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26
Q

Serous cystadenoma histology

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27
Q

Serous cystadenoma histology

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28
Q

Serous cystadenoma with psammoma body histology

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29
Q

Serous borderline tumor histology

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30
Q

Ovarian serous adenocarcinoma gross histology

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31
Q

Ovarian serous adenocarcinoma histology

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32
Q

Ovarian serous adenocarcinoma histology

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33
Q

Ovarian serous adenocarcinoma in lymphatic space

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34
Q

Ovarian serous adenocarcinoma with lymph node metastasis

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35
Q

Mucinous tumors of the ovary

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36
Q

Mucinous tumors of the ovary

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37
Q

Ovarian mucinous adenocarcinoma gross histology

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38
Q

Benign mucinous cystadenoma histology

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39
Q

Benign mucinous cystadenoma histology

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40
Q

Mucinous borderline tumor histology

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41
Q

Ovarian mucinous adenocarcinoma Malignant histology

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42
Q

Ovarian mucinous adenocarcinoma metastatic to peritoneum Malignant

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43
Q

Appendiceal mucinous adenocarcinoma

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44
Q

Endometrioid tumors of the ovary

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45
Q

Ovarian endometrioid adenocarcinoma

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46
Q

Transitional cell tumors of ovary

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47
Q

Ovarian Transitional cell tumor histology

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48
Q

Question

A

D. Mucinous tumor

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49
Q

Origins of ovarian tumors

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50
Q

Germ cell tumors

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51
Q

Germ cell lineages

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52
Q

Germ cell tumor lineages

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53
Q

Mature Teratomas AKA

A

Dermoids

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54
Q

Mature Teratomas

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55
Q

Gross histology of Mature Teratomas

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56
Q

Mature Teratomas gross hitology

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57
Q

Mature Teratomas histology

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58
Q

Mature Teratomas histology

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59
Q

Mature Teratomas histology

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60
Q

Mature Teratomas histology

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61
Q

Malignant teratomas

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62
Q

Malignant teratomas

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63
Q

Malignant teratomas histology

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64
Q

Malignant teratomas histology

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65
Q

Malignant teratomas histology

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66
Q

Dysgerminoma

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67
Q

Dysgerminoma gross histology

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68
Q

Dysgerminoma histology

A
69
Q

Dysgerminoma

A
70
Q

Uncommon ovarian germ cell tumors

A
71
Q

Choriocarcinoma histology

A
72
Q

Choriocarcinoma

A
73
Q

Yolk Sac Tumor

A
74
Q

Sex cords

A
75
Q

Sex cord stromal tumors

A
76
Q

Functional sex cord-tumors

A
77
Q

Functional ovarian tumor side effects

A
78
Q

Granulosa cell tumor

A
79
Q

Granulosa cell tumor gross histology

A
80
Q

Granulosa cell tumor histology

A
81
Q

Granulosa cell tumor histology

A
82
Q

Sertoli-Leydig cell tumors

A
83
Q

Sertoli-Leydig cell tumors gross histology

A
84
Q

Sertoli-Leydig cell tumors histology

A
85
Q

Sertoli-Leydig cell tumors histology

A
86
Q

Question

A

B and D

Granulosa cell tumor (estrogen and inhibin)

Thecoma (estrogen)

both can be functional tumors

87
Q

Non functional sex cord-stromal tumors

A
88
Q

OVarian fibroma

A
89
Q

Ovarian fibrosarcoma

A
90
Q

metastatic tumors to the ovary

A
91
Q

Ovary surface embryological origin

A
  • Coelomic epithelium -> ovary surface
92
Q

Ova embryological origin

A

Primordial germ cells

93
Q

Background stroma and sex cords embryological origin

A

Undifferentiated mesenchyme

94
Q

Labs of Polycystic Ovarian Syndrome

A

Characterized by High LH and Low FSH ( LH:FSH > 2)

95
Q

Symptoms of Polycystic Ovarian Syndrome

7 listed

A
  • Anovulation, Oligomenorrhea and/or infertility
  • Obesity
  • Hirsutism, Acne
  • Non-insulin dependent diabetes
  • HTN
  • Sclerocystic change
96
Q

What is the most common ovarian tumor?

A

Ovarian epithelial neoplasms

97
Q

Ovarian epithelial neoplasms age of onset

A
  • most common in women over 50
98
Q

Ovarian epithelial neoplasms features

A

May be bilateral

Multiple histologic types:

  • Serous
  • Mucinous
  • Endometrioid

Has three stages of biologic behavior

  1. Benign
  2. Borderline
  3. Malignant
99
Q

Etiology of Ovarian epithelial neoplasms

A

Sever theories of origin exist:

  • MEtastasis from fallopian tube primary tumor
  • Possibly via ovulation with ovarian surface breaks to release Ova and heals to include cysts of surface epithelium inside ovarian parenchyma
  • This followed by tissue metaplasia where one tissue type changes into another
100
Q

How do ruptured follicles heal

A

cortical inclusion cyst (includes some ovary surface stuff)

101
Q

What is a Cortical Inclusion Cyst?

A

Healed ruptured follicle from ovulation which includes some surface cells and material

102
Q

Cell types of Ovarian epithelial neoplasms

A
  • Serous (tubal)
  • Mucinous
  • Endometrioid
  • Clear cell
  • Transitional (bladder)
103
Q

Biologic grades of Ovarian Epithelial Cystic Neoplasms

A
  • Benign cystadenoma (70%) *Single-cell layer*
  • Borderline (low-malignant potential)
  • Malignant invasive carcinoma
104
Q

most common type of ovarian epithelial tumor

A

More than 50% are Serous tumors of the ovary

105
Q

Risk factors for ovarian epithelial tumors

A

most common is Serous tumors of the ovary

  • Nulliparity
  • FHx: BRCA1 mutation (40% lifetime risk)
  • BRCA2 (10% lifetime risk)
106
Q

Protective factors against ovarian epithelial tumors

A
  • High parity
  • OCPs
107
Q

Features of serous tumors of the ovary

A
  • most common type of ovarian epithelial tumor
  • Tubal/surface epithelium sometimes with psammoma bodies
  • Can be nenign, borderline or malignant adenocarcinoma
  • Serous adenocarcinomas may spread diffusely throughout the abdomen
  • CA-125 useful serum marker to monitor treatment and recurrence
  • often bilateral, typically cystic filled with watery serous fluid
108
Q

Prevalence of Mucinous tumors of the ovary

A

25% of ovarian tumors

109
Q

Features of Mucinous tumors of the ovary

A
  • Usually unilateral
  • mucinous endocervical or enteric-type epithelium
  • can be benign, borderline or adenocarcinoma
  • often large cystic masses filled with mucinous fluid
  • Uncommonly spreads outside the ovary
  • Pseudomyxoma peritonei
110
Q

What is Pseudomyxoma peritonei?

A
  • a Mucinous tumor of the ovary metatastic to the peritoneum
  • mucinous ascites and tumor implants on peritoneal surfaces
  • may cause intestinal obstruction and death
  • Mimicked by metastasis from appendix/colon
  • Check colon and perform appendectomy at time of surgery
111
Q

Prevalence of Endometrioid tumors of the ovary

A

20% of ovarian tumors

112
Q

Features of Endometrioid tumors of the ovary

A
  • microscopic appearance of uterine endometrial carcinoma
  • 15-20% arise associated of uterine endometrial carcinoma
  • 15-20% arise associated with ovarian endometriosis
  • Can be benign, borderline or adenocarcinoma
  • Ovarian and uterine endometrial carcinoma iften occur together (15-20%)
  • concurrent independent primaries or Metastases?
113
Q

Features of Transitional cell tumors of the ovary

A
  • Borderline and carcinoma forms are rare
  • may be solid or cystic with mucinous component
  • Rare ovarian transitional carcinomas resemble bladder carcinoma
114
Q

What is the Benign form of Transitional cell tumors of the ovary?

A

Benign form = Brenner tumor

which is the most common form of Transitional cell tumors of the ovary

115
Q

What is the most common form of Transitional cell tumors of the ovary

A

Brenner tumor (benign form)

116
Q

Features of Brenner tumor

A
  • The most common and benign form of Transitional cell tumors of the ovary
  • Resembles bladder epithelium
117
Q

Serous tumors of the ovary useful serum marker

A

CA-125 useful to monitor treatment and recurrence

118
Q

What is the most common type of Germ Cell tumor?

A

Mature Teratomas

119
Q

Epithelial carcinomas embryonal tissue

A

Coelmic epithelium

120
Q

Germ cell tumors embryonal tissue

A

Primordial germ cells

121
Q

Sex cord and stromal tumors embryonal tissue

A

Undifferentiated mesenchyme

122
Q

Teratoma germ cell tumor lineage

A

Fetus

123
Q

Choriocarcinoma germ cell tumor lineage

A

Placenta

124
Q

YST germ cell tumor lineage

A

Extraembryonic membranes

125
Q

Dysgerminoma germ cell tumor lineage

A

Germ cells

126
Q

Seminoma germ cell tumor lineage

A

Germ cells

127
Q

Embryonal carcinoma germ cell tumor lineage

A

Primitive tissue

128
Q

Dermoids AKA

A

Mature Teratomas

129
Q

Mature teratomas age of onset in women

A

Seen in reproductive aged women

130
Q

Mature teratomas composed of?

A

All three fetal germ cell layers:

Mature endoderm

Mature ectoderm

Mature endoderm

131
Q

Mature teratomas diagnosis

A

can be diagnosed radiologically by the presence of bone or teeth

132
Q

What is Struma ovarii?

A

A form of teratoma comprised of thyroid tissue, may be functional with hyperthyroidism

133
Q

Mature teratomas mechanisms of malignancy?

A
  • malignant transformation of mature teratoma: squamous cell carcinoma, adenocarcinoma, chondrosarcoma, etc.
  • Immature (and malignant) tissues rather than mature; embryonic tissues
  • Very aggressive tumors often wth poor prognosis
134
Q

What is the most common malignant germ cell tumor seen in reporductive aged women

A

Dysgerminoma

135
Q

Germ cell tumor associated with Turners Syndrome

A

Dysgerminoma

136
Q

Dysgerminoma is associated with

A

Turner Syndrome

137
Q

Dysgerminoma histological features

A

solid tumor with sheets of uniform cells admixed with lymphocytes

138
Q

Dysgerminoma lab markers

A

Serum LDH may be elevated

139
Q

Choriocarcinoma is associated with?

A

usually pregnancy related

140
Q

Choriocarcinoma lab markers

A

Elevated bhCG

141
Q

Choriocarcinoma histological features

A

placental-like with malignant trophoblasts

142
Q

Features of YST

A
  • Aggressive malignant tumor
143
Q

YST lab markers

A

AFP high

144
Q

YST histological features

A
  • Schiller-Duval bodies
  • PSA+ hyaline-like globules
  • glomerulus like structures
145
Q

Features of embryonal carcinoma

A

aggressive malignant tumor with large primitive cells

146
Q

What are sex cords?

A

embryonic tissues which produce the gonadal stroma (background support tissue)

in females give rise to granulosa and theca cells

In males give rise to Sertoli and Leydig cells

in both sexes background stroma is composed of fibroblasts

147
Q

Female sex cord-stromal tumors

A
  • Granulosa cell tumor
  • Thecoma
  • Sertoli-Leydig cell tumor (can also be in men)
  • fibroma and fibrosarcoma
148
Q

Male sex cord-stromal tumors

A
  • Sertoli-Leydig cell tumor (also in women)
  • Fibroma and fibrosarcoma
149
Q

What is a functional sex cord-stromal tumors

A

functional refers to the ability of a tumor to produce sex hormones and the clinical effects of hyperestrinism and hypertestosteronism

150
Q

Functional sex cord-stromal tumors

A
  • Granulosa cell tumor - Estrogen and inhibin
  • Thecoma - estrogen
  • Sertoli-Leydig cell tumor - testosterone
151
Q

Hyperestrinism from functional granulosa or thecoma tumor

A

elevated estrogen typically produces abnormal uterine bleeding in post-menopausal women

152
Q

Hypertestosteronism from functional Sertoli-Leydig cell tumor

A

loss of female secondary sex characteristics, hirsutism, balding, breast atrophy, coive deepining, amenorrhea

153
Q

Granulosa cell tumor age of onset

A
  • seen at any age but more common in post-menopausal women
  • Juvenile Granulosa cell tumors seen in girls with precocious puberty
154
Q

Granulosa cell tumor aggression?

A

Rare malignant tumor

155
Q

Granulosa cell tumor clincial effects of estrogen production

A

Abnormal uterine bleeding which may indicate concurrent endometrial hyperplasia or carcinoma

Solid tumors secrete inhibin which can be used as a biomarker for monitoring

156
Q

Granulosa cell tumor histological features

A
  • “coffee bean” nuclei with nuclear grooves
  • Call-Exner bodies
  • small follicles with eosinophilic secretions
157
Q

Juvenile Granulosa cell tumor

A

seen in girls with precocious puberty

158
Q

Sertoli-Leydig cell tumors age of onset

A

seen in young women (average age of 25 years)

159
Q

Sertoli-Leydig cell tumors likelihood of being functional

A

about 30% are virilizing with elevated serum testosterone; remainder with no hormonal effects

160
Q

Histological features of Sertoli-Leydig cell tumors

A

solid tumors with two cell types:

Sertoli cells

Leydig cells (Reinke crystals)

161
Q

Reinke crystals are seen in?

A

Sertoli-Leydig cell tumors in the Leydig cells

162
Q

Sertoli-Leydig cell tumors aggression

A

may be poorly differentiated and at an advanced stage when discovered for a poor prognosis

163
Q

Most common Non-functional Sex cord-stromal tumors

A
  • Ovarian fibroma is the most common stromal tumor
164
Q

Ovarian fibroma age of onset?

A

typically seen in middle-age and often combined with thecomas (functional)

165
Q

Histological features of Ovarian fibroma

A

solid very firm benign tumors composed of fibroblasts

Malignant variants may occur and are called fibrosarcomas

166
Q

Ovarian fibroma aggression

A

benign but malignant variants may occur and are called fibrosarcomas

167
Q

Ovarian fibroma associated with

A
  • Often occur along with functional thecomas
  • May be associated with pleural effusions and ascites (Meigs Syndrome)
168
Q

Ovarian fibrosarcoma histology

A
169
Q

Features of metastatic tumors of the ovary

A
  • majority are bilateral
  • often intramullerian (fallopian tube and endometrium)
  • Extramullerian (GI tract, colon, appendix, stomach (Krukenberg), breast)

Human Reproduction (40 decks)

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