Ovarian Pathology Flashcards

(42 cards)

1
Q

What may ovarian pathology appear as?

A
  • pain (severe with TORSION - acute)
  • swelling (appear 40 wks pregnant)
  • endocrine effects
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2
Q

Main ovarian pathologies?

A
  • cysts
  • endometriosis
  • tumors
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3
Q

What are the diff. types of ovarian cysts?

A
  • follicular (benign and resolves in few months)
  • luteal (benign)
  • endometriotic (blood filled)
  • epithelial (benign/malign.)
  • mesothelial
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4
Q

What is a red flag when it comes to cysts?

A
  • High solid content

- high CA125 level

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5
Q

Why may a follicular cyst occur?

A
  • when ovulation doesn’t occur (PCOS)

- follicle doesn’t rupture but GROWS until it becomes a cyst (can grow to to several cm)

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6
Q

What may endometriosis cause?

A
  • pelvic inflammation–> SCARRING
  • infertility (d.t adhesions blocking the fallopian tubes)
  • PAIN
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7
Q

Why may endometriosis occur?

A
  • REGURGITATION
  • METAPLASIA (forming endometrial glands; doesn’t explain the stroma)
  • vascular and lymphatic dissemination
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8
Q

How does enodmetriosis present as?

A
  • peritoneal spots/ nodules
  • fibrous ADHESIONS
  • chocolate cysts
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9
Q

How does enodmetriosis present as?

A
  • peritoneal spots/ nodules (very dark red/black)
  • fibrous ADHESIONS
  • chocolate cysts
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10
Q

WHat are complications of endometriosis?

A
  • Pain
  • Cyst formation
  • Adhesions
  • Infertility—-fusion of cilia in the the tubes or the fimbraie (OBSTRUCT. of blastocyst movement)
  • Ectopic pregnancy
  • Malignancy (endometrioid carcinoma)
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11
Q

What are the diff. types of ovarian tumors?

A
  1. Surface epithelial (MOST COMMON)
  2. germ cell
  3. Sex-cord/ stromal
  4. metastatic
    ( Miscellanous)
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12
Q

What is a red flag for the constituency of ovarian tumors?

A
  • cystic and solid is BAD
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13
Q

What are the types of epithelial ovarian tumors?

A
Serous * (high and low grade) -----can be a SMALL aggressive tumor
Mucinous*
Endometrioid*
Clear cell *
Brenner*
Undifferentiated carcinoma
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14
Q

How may epithelial tumors be classified?

A
  • bening/ malignant/ borderline
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15
Q

How is borderline tumor diff from benign tumors?

A
  • benign: no stromal invasion, no cytological abnormalities, absent proliferative activity
  • borderline: has cytological abnormalities and proliferation, NO stromal invasion
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16
Q

If HIGH or low grade serous CA more common?

A
  • HIGH grade
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17
Q

What is suggested with surgical management of serous ca?

A

REMOVE ovaries and tubes !

18
Q

What is endometroid tumors a.w?

A
  • strongly a.w endometriosis
  • —–most are low grade and EARLY stage
  • —association with LYNCH Syndrome
19
Q

Which epithelial ovarian tumor has a strong a.w endometriosis?

A
  • Endometroid and Clear Cell carcinoma

—- both also a.w Lynch Syndrome

20
Q

Which ovarian CA has GOOD prognosis?

A
  • Endometroid ca of the ovary
21
Q

Primary dx of ovarian tumors is made on _______

A

ASCITIC fluid

22
Q

Which sex-cord tumors produce estrogen?

A

Fibroma tumor

Granulosa Cell tumor

23
Q

Commonest location from where metastatic tumors arise from?

A
  • stomach
  • colon
  • breast
  • pancreas
24
Q

Fallopian tubes pathology?

A
  • inflammation
  • cysts and tumors
  • endometriosis
  • ectopic prgenancy
  • serous tubal intraepithelial ca
25
Danger of an ectopic pregnany?
fatal hemorrhage
26
What does the serous tumor arise from...?
- background of tubal intraepithelial neoplasia
27
What is a follicular cyst lined by?
- granulosa cells
28
How to tell a Malignant epithelial ovarian tumor apart from borderline one?
- Stromal invasion is PRESENT in the malignant type
29
What is the precursor lesion of High grade SEROUS carcinoma?
- STIC - serous tubal intraepithelial carcinoma - ---most are TUBAL in origin
30
What is the precursor lesion of the low grade serous carcinoma?
- serous borderline tumor
31
Most endometroid CA are at what stage _____
LOW stage and early
32
What gross distinction can be made by the appearance of serous neoplasia (benign and borderline) on slide 19?
- borderline: papillary appearance (not distinct masses; ragged)
33
What is the brenner tumor usually?
BENIGN | others are rare
34
Which type of ovarian tumor comprises of 15-20% of ovarian tumors?
- Germ cell tumors ------Dermoid cyst (mature- benign and cystic)
35
Name the diff. types of germ cell tumors.
- mature teratoma - immature teratoma - yolk sac tumor - choriocarcinoma - mixed germ cell tumor
36
Who is exclusively affected by dysgerminoma?
- CHILDREN | - young women (~avg age 22)
37
When should metastatic ovarian tumors be considered?
- when ovarian tumors are BILATERAL and small!
38
What are the stages of Figo Staging in ovarian cancer?
``` 1A: limited to ONE ovary . . 1C: involved ovarian surface/ rupture/spill . . 2A: extension to uterus/tube 2B: ext. to other pelvic intraperitoneal ```
39
At what stage in FIGO does it highlight peritoneal metastasis?
3B: peritoneal metastasis BEYOND pelvis (<2cm) 3C: peritoneal metastasis >2cm
40
Define ectopic pregnancy.
implantation of conceptus OUTSIDE the endometrial cavity
41
When is ectopic pregnancy considered as a ddx in a female?
- when any female of a reproductive age comes in with amennorhea, acute hypotension or acute abdomen
42
What are the 4 diff. sites of ectopic pregnancy?
ovarian tubal interstitial cervical