Gynecologic Pathology III

Question 1

T/F cystadenomas are benign

Answer 1

T

Question 2

Ovarian tumor sources

Answer 2

surface epithelial, germ cell, sex-cord stromal, metastatic

Question 3

What is the source of borderline tumors?

Answer 3

surface epithelia

Question 4

Most common source of benign, malignant, and borderline ovarian tumors?

Answer 4

surface epithelia

Question 5

Epithelial tumors arise form the surface epithelium of the ovary and from _____

Answer 5

epithelial inclusion cysts

Question 6

Inclusion cyst formation

Answer 6

after ovulation, invagination of surface epithelium can form a cyst

Question 7

Classification of surface epithelial tumors

Answer 7

serous, mucinous | malignant, borderline, benign

Question 8

______ are lined by a single layer of bland epithelial cells.

Answer 8

benign cystadenomas

Question 9

Ovarian masses that are ______ are most suspicious for malignancy

Answer 9

solid and cystic

Question 10

Completely cystic masses are mostly benign/malignant

Answer 10

benign

Question 11

T/F Completely solid masses may be benign or malignant

Answer 11

T

Question 12

Typical spread of ovarian cancer

Answer 12

peritoneal surfaces, omentum

Question 13

T/F most early stage ovarian cancers come without signs and symptoms

Answer 13

T

Question 14

Stage I ovarian cancer

Answer 14

a = one ovary, b = both ovaries, c = surface/rupture of ovary

Question 15

Stage 2 ovarian cancer

Answer 15

spread to tubes, uterus, other pelvic organs

Question 16

Stage 3 ovarian cancer

Answer 16

lymph node metastasis, spread out of pelvis or to omentum

Question 17

Stage 4 ovarian cancer

Answer 17

distant metastasis

Question 18

Most common malignant ovarian tumor

Answer 18

ovarian serous carcinoma

Question 19

Risk factors for ovarian serous carcinoma

Answer 19

nulliparity, family hx, heritable mutations

Question 20

Which heritable mutations are risk factors for ovarian serous carcinoma

Answer 20

BRCA1 or BRCA2

Question 21

Which mutations tend to lead to low grade ovarian serous carcinoma (e.g. serous borderline tumors) ?

Answer 21

KRAS or BRAF

Question 22

Which mutations tend to lead to high grade ovarian serous carcinoma?

Answer 22

p53

Question 23

Almost all ovarian carcinomas in women with ______ mutations are high grade serous carcinoma and a significant percentage of these arise from _______

Answer 23

BRCA 1/2 and fallopian tube epithelium

Question 24

T/F Most serous tumors are malignant vs borderline or benign

Answer 24

T

Question 25

Borderline tumors have high/low malignant potential.

Answer 25

low

Question 26

Is there invasion in borderline tumors?

Answer 26

No stromal invasion!

Question 27

Implants

Answer 27

not considered metastases --> extraovarian lesions with borderline tumors

Question 28

borderline tumors with invasive implants act like ____

Answer 28

low grade carcinomas

Question 29

Stage I borderline ovarian tumors

Answer 29

confined to ovary; if noninvasive implants --> 100% survival

Question 30

Metastatic tumors of ovary are hard to distinguish from ___

Answer 30

primary mucionous ovarian tumors

Question 31

Primary ovarian mucinous tumors are almost always uni/bilateral and large/small

Answer 31

unilateral and large

Question 32

Metatstatic tumors of the ovary tend to be uni/bilateral and small/large

Answer 32

bilateral and small

Question 33

Krukenberg tumor

Answer 33

special form of bilateral metastasis to ovary that is solid

Question 34

Classical Krukenberg histology

Answer 34

signet ring tumor cells --> breast and stomach cancer

Question 35

Germ cell ovarian tumors are ____ >95% of the time

Answer 35

benign dermoid cyst/cystic teratoma

Question 36

For 0-30 year old age group, ___ are hte most common malignant tumors.

Answer 36

dysgerminoma (germ cell tumor)

Question 37

dermoid cyst

Answer 37

benign, common form of germ cell tumor in ovary

Question 38

malignant transformation of a dermoid cyst is rare/common

Answer 38

rare

Question 39

Dysgerminoma

Answer 39

uncommon but most common malignant germ cell tumor --> can be bilateral; excellent prognosis

Question 40

Sex cord stromal tumors arise from ____

Answer 40

granulosa and thecal cells

Question 41

Most benign granulosa-stromal cell tumors are

Answer 41

thecoma-fibroma

Question 42

Most of clinically malignant sex-cord stromal tumors are ___

Answer 42

granulosa cell tumors --> all have malignant potential

Question 43

Granulosa cell tumors can produce estrogens and cause _____

Answer 43

endometrial hyperplasia/carcinoma

Question 44

granulosa cells in tumors form follicles called ___

Answer 44

call-exner bodies

Question 45

coffee bean nuclei with grooves

Answer 45

granulosa cell tumor

Question 46

____ tumors have a lot of lipid

Answer 46

thecoma

Question 47

____ tumors have no hormone production and are associated with two rare syndromes

Answer 47

ovarian fibroma

Question 48

two syndromes associated with ovarian fibroma

Answer 48

meigs, gorlins

Question 49

meigs' syndrome

Answer 49

ascities and pleural effusion

Question 50

gorlins' syndrome

Answer 50

nevoid basal cell carcinoma syndrome --> multiple fibromas

Question 51

bundles of spindle cells are what kind of tumor?

Answer 51

ovarian fibroma