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Pathology > Weibliche Geschlechtsorgane - Ovaries > Flashcards

Weibliche Geschlechtsorgane - Ovaries Flashcards

0
Q

Follicle and luteal cysts

  1. How big are they (normally)?
  2. What is inside these cysts?
A

1.
1-1,5 cm in diameter

2.
They are filled with clear serous fluid

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1
Q

Follicle and luteal cysts

  1. How common are they?
  2. How dangerous are they?
A
  1. Extremely common

2. They are innocuous (harmlos)

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2
Q

Follicle and luteal cysts

What happens if they become bigger?

A

If they became around 5 cm, they become palpable masses

-> this may cause pelvic pain

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3
Q

Follicle and luteal cysts

What symptoms may they make?

A
  • Pelvic pain due a size of 5 cm
  • these cysts may rupture -> intraperitoneal bleeding
    and acute abdomen!!!!!
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4
Q

Polycystic ovarian disease

  1. How is the polycystic ovarian disease also called?
A
  1. Stein-leventhal syndrome
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5
Q

Polycystic ovarian disease

How is affected? (4)

A

Teenage girls and young adults after menarche with:

  • oligomenorrhea
  • hirsutism - Frauen mit Haar
  • infertility
  • and sometimes obesity
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6
Q

Polycystic ovarian disease

How big are the ovaries of these girls?

How do they look in histologic examination?

A

Twice the normal size

Histologic examination:

  • capsule is thickened and fibrotic
  • innumerable cystic follicles
  • a hyperplastic luteinized theca interna
  • abscence of corpora lutea in the ovary
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7
Q

Polycystic ovarian disease

How does this disease influrences the hormons?

A
  • high androgen production
  • high concentration of luteinizing hormone
  • low concentration of follicle-stimulating hormone (FSH)
  • estrogen high!!!
    [androgens produces-> converted to estrogen in fatty depots
    -> estrogen inhibits FSH]
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8
Q

Tumors of the ovary

  1. Name the orgin of the four kinds of ovary tumors!
  2. What is the most common type?
A 
1. surface epithelial cells - 70% / 90% of all malignant ovarian 
    tumors
2. Germ cells - 15%
3. Sex cord-Stroma - 5-10%
4. Metasis to ovaries - 5%
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9
Q

Tumors of the ovary - Surface Epithelial Tumors

Name the six types of surface epithelial tumors!

A
  1. Serous tumors
  2. Mucinous tumors
  3. Endometrioid tumors
  4. Clear cell tumors
  5. Brenner tumors
  6. Cystadenofibroma
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10
Q

Tumors of the ovary - Surface Epithelial Tumors

  1. From what is the vast majority of ovarian neoplasms derived
    (abgeleitet) ?
A
  1. From the coelomic epithelium that covers the surface of the
    ovary
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11
Q

Tumors of the ovary - Surface Epithelial Tumors

  1. What is the precursor of Surface Epithelial Tumors?
    And how do they develop?
  2. What can happen with these precursors?
A
  1. The precursor are epithelial cystsWith repeated ovulation and scarring, surface epithelium
    becomes entrapped (gefangen) in the cortex of the ovary,
    forming small epithelial cysts
  2. These epithelial cysts can become metaplastic or undergo
    neoplastic transformations to give rise to a number of different
    epithelial tumorsBening lesions: cysts (cystadenoma) and may have additionally
    a stroma component (cystadenofibroma)Malignant tumors:
  • may be cystic (cystadenocarcinoma)
  • or may be solid (carcinoma)
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12
Q

Tumors of the ovary - Surface Epithelial Tumors

What are the important risk faktors for ovarian cancer?

A
  1. nulliparity -> keine Kinder geboren
  2. family history
  3. germline mutations: BRCA1 and BRCA2
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13
Q

Tumors of the ovary - Surface Epithelial Tumors

What shrinks the probability of ovary tumors?

A

Oral contraceptives somewhat(etwas) reduces the risk

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14
Q

Tumors of the ovary - Surface Epithelial Tumors
- Serous Tumors-

  1. How many serous tumors of the ovary surface are benign?
  2. How old are patient with benign serous tumor and malign
    serous tumor?
A
  1. 60% (15% low maligne and 25% malignant)
  2. benign lesions: women between 30-40 years of age
    Malign lesions: women between 45-65 years of age
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15
Q

Tumors of the ovary - Surface Epithelial Tumors

  • Serous Tumors-
    1. name the two types of serous tumors!
A

Low-grade and high grade tumors

Both have a different gen anomaly

16
Q

Tumors of the ovary - Surface Epithelial Tumors
- Serous Tumors-

  1. How are serous tumors shaped?
  2. are serous tumors of the ovary uni- or bilateral?
A
  1. large 3-40 cm
    sperical to ovoid
  2. About 25% bilateral
    And about 75% unilateral
17
Q

Tumors of the ovary - Surface Epithelial Tumors
- Serous Tumors-

  1. How does a benign serous tumor look macroscopically?
    How does a malignant tumor look?
  2. How does a benign serous tumor looks histologically?
A
  1. benign tumor: the serosal covering is smooth and glistening
    Cystadenocarcinoma has nodular irregulations, representing
    areas in which the tumor has penetrated into the serosa
    2.

a)
Benign tumors contain a single layer of tall columnar epithel cells (Plattenepithel) that line the cyst or cysts

b)
Psammoma bodies (concentrically laminated calcified concretions) are common in the -> tips of papillae

c)
When carcinoma develops -> anaplasia of lining cells appears
and ivasion of the stroma

d)
In carcinoma, papillary formations are complex and multilayered
e)
and nests (Nester) or undifferentiated sheets of malignant cells
invade the axial fibrous tissue

18
Q

Tumors of the ovary - Surface Epithelial Tumors
- Mucinous Tumors-

  1. Out of what does the neoplastic epithelium consists?
  2. are they less or more like to be malignant than serous tumors?
A
  1. it consists of mucin-secreting cells

2. less likely to be malignant

19
Q

Tumors of the ovary - Surface Epithelial Tumors
- Mucinous Tumors-

  1. Macroscopically what are the differences and the similarities
    between mucinous tumors and serous tumors?
  2. How does a malignant tumor look like
A
  1. On gross examination: mucinous tumors produce cystic
    masses that may be indistinguishable from serous tumors!Mucinous tumors are more likely to be larger and multicystic

2.
Serosal penetration and solid areas of growth are suggestive
of malignancy!

Histologically: Architectural complexity, solid areas of growth,
cytologic atypia and stroma invasion an cellular
stratification(Schichtung)

20
Q

Tumors of the ovary - Surface Epithelial Tumors
- Mucinous Tumors-

  1. are they unilateral or bilateral?
A
  1. they are less likely to be bilateral than serous tumors
    -> good way to seperate ovary mucinous tumor from
    metastatic mucinous adenocarcinoma from the GI
    - called Krukenberg tumor (whicg often is bilateral)
21
Q

Tumors of the ovary - Surface Epithelial Tumors
- Endometrioid Tumors-

  1. What is their consistency?
  2. Sometimes they develop in association with what?
  3. On microskopic examination, what can you see?
  4. Are endometrioid ovary Tumots of the surface good or bad?
A
  1. Solid or cystic
  2. Sometimes endometrioid tumors develop with endometriosis
  3. formation of tubular glands
  4. They are usually malignant
22
Q

Tumors of the ovary - Surface Epithelial Tumors
- Brenner Tumors-

  1. What is their consistence? How do they look?
  2. Is this tumor benign or malignant?
  3. Sometimes Brenner tumor can do what?
  4. How old are affected Women?
A

1.

  • solid
  • smoothly encapsuled
  • usually unilateral
  • Gray-White, few cm to 20 cm
  • abundant (reichlich) Stroma which contains nests of
    transitional-type epithelium (Urethel)
  1. Most are benign
  2. Produces estrogen, in some cases
  3. on the other side of 50
23
Q

Germ cell tumors of the ovary

  1. What is the number 1 germ cell tumor?
A
  1. teratoma -> Teratom ist nummer 1 Keimzelltumor des ovar
24
Q

Germ cell tumors - Teratomas

  1. How many ovarian tumors are teratoms?
  2. When does this tumor occure?
  3. When is this tumor very malignant?
A
  1. 15-20% of ovarian tumors are teratomas!
  2. It can come anytime but likes to come from 0-25
  3. the younger the person the greater the likelihood of malignancy
    However, more than 90% of these tumors are benignMature (reif) teratomas are benign and immatures are malignant
25
Q

Germ cell tumors - Teratomas

  1. What do mature teratomas may cause?
  2. What is so special with regard to teratomas?
A
  1. infertility for unknown reasons
  2. Keimzelle/ Germ cells-> 3 Germ cell layers -> Tumor with Hair,
    Brain tissue, tooth etc.
26
Q

What is the most common ovarian tumor in young women?

A

Germ cell tumors -> most cystic teratomas

Pathology (12 decks)

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