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Ovarian Pathology Flashcards

1
Q

When do follicular cysts form?

A

When ovulation doesn’t occur properly and the follicle fials to rupture e.g. seen in PCOS

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2
Q

Give some characteristics of follicular cysts

A

Can be several cm in size
Thin walled
Lined with granulosa cells
Tend to resolve after a few mon ths

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3
Q

What is the term used for endometriosis of the ovaries?

A

Chocolate cysts

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4
Q

What is endometriosis?

A

A condition characterised by endometrial glands and stroma found outwith the uterine body

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5
Q

What are some of the complications of endometriosis

A 
Pelvic inflammation
Cysts formation
Extreme pain
Infertility 
Ectopic pregnancy
Malignancy (less common)
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6
Q

What is seen macroscopically in endometriosis?

A

Peritoneal spots/nodules
Fibrous adhesions
Chocolate cysts

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7
Q

What is seen microscopically in endometriosis?

A

Endometrial gland and srtoma
Haemorrhage
Inflammation
Fibrosis

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8
Q

What is the most common ovarian tumour?

A

Epithelial

Accounts for 65-70% of ovarian tumours

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9
Q

What defines a benign epithelial ovarian tumour?

A

No cytological abnormalities
No proliferative activity
No stromal invasion

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10
Q

When is an epithelial ovarian tumour considered borderline?

A

Has cytological abnormalities and proliferative activity but NO stromal invasion

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11
Q

What classifies an epithelial tumour as malignant?

A

Proliferative activity
Cytological abnormalities
Stromal invasion

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12
Q

Most cases of serous ovarian carcinomas are ____ in origin?

A

Tubal

Known as serous tubal intraepithelial carcinomas

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13
Q

How is a primary diagnosis of ovarian tumour made?

A

Through ascitic fluid aspiration

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14
Q

Define a Brenner tumour:

A

A tumour of transitional type epithelium which is usually benign
Borderline/malignant versions are extremely rare

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15
Q

Germ cell tumours account for __% of all ovarian tumours?

A

15-20%

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16
Q

What is the most commonly found germ cell tumour?

A

Teratoma

17
Q

Germ cell tumours commonly are malignant? True/False

A

False

They are cystic in nature and rarely become malignant

18
Q

What is the most common malignant germ cell type?

A

Dysgerminomas

19
Q

Dysgerminoma’s typically affect what group?

A

Children and young women (average age 22)

20
Q

List 3 examples of sex cord/stromal tumours

A

Fibroma/Thecoma
Granulosa Cell
Sertoli-Leydig

21
Q

Which sex-cord cell tumour are rare but can produce androgens?

A

Sertoli-Leydig

22
Q

What must you consider if you find small bilateral ovarian tumours?

A

Metastases from elsewhere

23
Q

Which sex-cord/stromal tumours are usually malignant and associated with oestrogenic manifestations?

A

Granulosa Cell

24
Q

Which sex-cord/stromal cell tumour is benign and associated with uterine bleeding?

A

Fibromas/Thecomas

can produce oestrogen, hence uterine bleeding

25
Q

Give some common sites of primary tumours which metastasize to the ovaries?

A

Stomach
colon
Breast
Pancreas

26
Q

What are the three features of Meig’s syndrome?

A

Pleural Effusion
Benign Fibroma
Ascites

27
Q

List some of the presenting symptoms of ovarian cancer:

A 
Heartburn/indigestion
Early satiety
Weight loss/anorexia
Bloating
Pressure symptoms (esp. bladder) 
Change in bowel habit
SOB
Leg oedema (or generalised oedema)
28
Q

What % of ovarian tumours have a genetic basis?

A

5%

29
Q

List some risk factors for ovarian cancer:

A

Increased age >50
Nulliparity
FHx +ve

30
Q

What 2 tumour markers can be used in the investigations of ovarian cancer:

A 
CA 125 (raised in >80% of ovarian tumours)
CEA
31
Q

Other than ovarian cancer, what other pathologies can have a raised CA 125

A 
Endometriosis
Peritonitis
Pregnancy
Pancreatitis
Ascites
32
Q

What specific category of ovarian tumours is CEA likely to be raised in?

A

Mucinous tumours

33
Q

What is the main purpose for testing CEA

A

It excludes mets from a primary GI cancer

34
Q

What should you biopsy when concerned about ovarian cancer spreading?

A

The omentum

This is always biopsied after an oophorectomy/hysterectomy

35
Q

What ovarian condition is characterised by bilateral hyperplasia of the ovarian stroma clusters of luteinising cells throughout the stroma, along with an increase in androgens e.g. testosterone?

A

Ovarian stromal hyperthecosis

36
Q

What is the appropriate management of ovarian stromal hyperthecosis in pre and post menopausal women

A

Pre menopausal - COCP

Post menopausal - Bilateral oophorectomy

37
Q

What would the hormone levels typically look like in a premature ovarian failure?

A

Raised FSH and LH
Low oestradiol
Potentially raised prolactin levels

38
Q

What drugs are first line treatment for ovarian cancer?

A

Platinum based drugs e.g. carboplatin, taxol and cisplatin

39
Q

What chemotherapy combination is used to treat germ cell tumours of the ovaries (and testes)?

A

BEP

Bleomycin Etoposide and platinum

Reproduction (19 decks)

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