Ovarian Pathology I Flashcards Preview

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Flashcards in Ovarian Pathology I Deck (80):
1

follicular cyst

common - up to 5cm in size
no LH surge and cyst doesn't rupture

often resorb after 2-3 menstrual cycle
smooth walled unicameral cyst

2

corpus luteum cyst

opening from released egg seals off - CL to cyst

may resolve

may hemorrhage - or undergo torsion

3

chocolate cyst

endometriosis in ovary
glands and strom present

4

benign ovarian cysts

follicular and corpus luteum

5

sudden unilateral pain

ovarian torsion
-blood supply compromised

6

tx of torsion

unwind vessel or remove ovary

7

ovarian torsion diagnosis

rule out ectopic pregnancy

ultrasound

8

poycystic ovary disease

most common endo problem in women of reproductive age

stein-leventhal syndrome

9

oligomenorrhea, hyperandrogen, hirsutism, balding, obesity, acanthosis nigricans, diabetes

PCOD

10

to visualize ovaries

ultrasound

to see PCOD

11

hypercholesterol, anovulation, MMR, amenorrhea, infertility, acne, insulin resistance, obesity

PCOD

12

leathery plaque like lesion

acanthosis nigricans
-with PCOD

13

failure to conceive after 1 year of sex

infertility

14

likelihood of pregnancy over time

fecindidity

15

over 35 yo with increased day 3 FSH

menopause
-ovarian failure

waited too long to get pregnant

16

less than 35yo with progesterone >3

recent ovulation

17

anovulatory infertility

PCOS - high androgen
endocrinopathy - prolactin, TSH, FSH

18

ovulatory infertility

if have high progesterone

hysterosalpingogram - to examine tubes

-blocked - PID or mechanical
-patent - endometriosis, adhesions, uterine mass, anoaly

19

majority of ovarian tumors

borderline serous tumors 47%

20

ovarian cancer

late at presentation

older women - increased if 1st degree relative has it

21

genetics of ovarian cancer

BRCA 1 and 2
lynch II syndrome

22

prognosis of ovarian cancer

depends more on stage

overal 50% 5 year mortality

23

often bilateral

ovarian cancer

24

screening ovarian cancer

no effective way

25

CA125

for following prognosis of ovarian cancer

NOT for diagnosis**

26

majority of ovarian cancer

serosal epithelium

27

layers of follicle in ovary

theca interna
granulosa
theca externa

28

granulosa cell tumor

malignant

29

sertoli-leydig cell tumor

malignant

30

dermoid cyst

teratoma
-benign

31

ovary serosa

invaginates into coelomic cavity - covered by serosal membrane during embryogenesis

32

serous cystadenoma of ovary

benign
-lined by single layer of epithelium

33

serous borderline carcinoma of ovary

atypia - but no invasion

34

serous adenocarcinoma of ovary

type 1 - low grade - slow progression

type 2 - aggressive - high grade - present late
-worse prognosis if peritoneum spread and mets

35

ciliated cells

benign serous cystadenoma of ovary

36

ascites

with serosal seeding of ovarian tumor

37

tx of borderline carcinoma of ovary

remove

prognosis excellent usually

38

surface of ovary covered by neoplasm

exophytic papillary serous carcinoma

protrudes to outside of ovary

39

surface of ovary smooth

cystic papillary serous carcinoma

40

psammoma body

pathogmonic of serous tumor of ovary


also seen in thyroid and kidney neoplasms

41

bilateral mucinous cancer of ovary

rule out mets

least likely to be B/L**

42

pseudomyxoma peritonei

mucinous ascites

if mucinous tumor breaks

43

endometroid tumors of ovary

type 1 - PTEN and KRAS
type 2 - p53, CDH1, and MI

same pathogenesis as uterus

44

goal of surgery for mucinous cystadenoma

avoid rupture - b/c seeding can occur

45

endometroid carcinoma of ovary

indistinguishable from endometroid adenocarcinoma of endometrium

15-20% coexist

associated with PTEN, KRAS, and beta-catenin mutations

46

KRAS and BRAF mutations

low grade serous carcinoma

47

p53, BRCA1 mutation

high grade serous carcinoma

48

p53 positive
BRCA1 positive
high Ki67**
WT1 positive

high grade serous carcinoma

Ki67 - proliferative
WT1 - serous

49

estrogen receptor

expressed 2/3 cases of high grade serous carcinoma

50

lower abdominal pain, GI complaints, ascites, pelvic pressure

symptoms for surface epithelial tumors of ovary

51

cytology of ascites

common means of establishing tissue diagnosis

52

surgery for surface epithelial tumors of ovary

main stay of treatment

all visible tumor removed
-followed by chemo

BRCA - BCP and salpingo-oophorectomy

53

malignant ascites

with ovarian serous carcinoma

54

mets of ovarian ca

liver, lung, bone, brain

55

peritoneal carcinomatosis

can be seen on CT

omental caking**

56

low albumin gradient

peritoneal carcinomatosis - seeding of tumor

57

high albumin gradient ascites

cirrhosis
heart failure

58

inhibin

biomarker for granulosa - theca cell tumor**

granulosa cells

59

call-exner bodies

granulosa thecal cell tumor

60

granulosa theca cell tumor

hormone active - 75% produce estrogen

yellow cut surface

all ages

intermediate malignancy

61

ascites, pleural effusion, ovarian fibroma
-resolves with resection

meig syndrome

62

fibroma

common and B9

solid white hard fibrous tumor

thecoma - with lipid droplets

fibrothecomas

63

sertoli-leydig cell tumor

rare

50% produce androgens
-causing virilization

64

teratoma in children

malignant

65

teratoma in adult

benign

66

dermoid cyst

benign cystic teratoma

contain 2 or 3 germ lines

hair and keratin - teeth**

67

teeth on X-ray

diagnostic for teratoma

68

rokitanski nodule

in dermoid cysts - teratomas

69

immature teratoma

malignant

70

mature teratoma

benign

71

monodermal teratoma

single tissue teratoma

carcinoids
struma ovarii - thyroid

functional - hyperthyroid and carcinomd syndrome

72

flushing

carcinoid

73

dysgerminoma

all malignant

sensitive to radiotherapy

1/3 aggressive

U/L confined to ovary - can be treated with salpingo-oophorectomy

74

endodermal sinus tumor

yolk sac

alpha-fetoprotein
allpha-1 antitrypsin

very aggressive - need chemo

in children and young adults

75

schiller duval bodies

endodermal sinus tumor

76

AFP and a-1 antitrypsin

endodermal sinus tumor

77

choriocarcinoma

within part of another germ cell tumor

aggressive

produce beta-hCG

78

beta hCG

choriocarcinoma

for diagnosis

79

krukenberg tumor

B/L mets of mucin producing signet ring cancer cells

gastric origin

80

signet ring

krukenberg tumor