Pathologies of Ovarian Diseases- 1

Question 1

What are the two main regions of the ovarian stroma?

Answer 1

Cortical and medullary.

Question 2

What is the size of the ovary described?

Answer 2

4x2x1 cm.

Question 3

What are the stages of the ovarian follicle life cycle?

Answer 3

Primordial follicle, Mature follicle, Atretic follicle, Corpus Luteum, Corpus Albicans.

Question 4

What cells are found in a mature follicle?

Answer 4

Granulosa and theca cells.

Question 5

What do theca cells produce?

Answer 5

Sex steroids.

Question 6

What are non-neoplastic ovarian cysts?

Answer 6

Inclusion cysts, Follicular cysts, Luteal cysts, Polycystic ovary syndrome.

Question 7

What causes inclusion cysts?

Answer 7

Invagination of the surface epithelium.

Question 8

What is a solitary follicular cyst?

Answer 8

A cyst from uncracked Graafian follicles, usually 1-1.5 cm, filled with serous fluid.

Question 9

What symptoms can a ruptured follicular cyst cause?

Answer 9

Acute abdomen, pelvic pain.

Question 10

What is Hyperreaction Luteinalis?

Answer 10

Bilateral ovarian enlargement due to multiple luteinized follicle cysts, caused by high hCG levels.

Question 11

What are the key features of Polycystic Ovary Syndrome (PCOS)?

Answer 11

Bilateral cysts, anovulation, menstrual irregularities, hirsutism, obesity.

Question 12

What is Stromal Hyperthecosis?

Answer 12

Luteinized cells in extra-follicular areas, often in the medulla, causing virilization.

Question 13

What is Stromal Hyperplasia?

Answer 13

Associated with endometrial carcinoma, obesity, hypertension, glucose intolerance.

Question 14

What is Ovarian Fibromatosis?

Answer 14

Fibromatoid proliferation of spindle cells, causing amenorrhea, abdominal pain.

Question 15

What is Endometriosis Externa?

Answer 15

Extra-uterine endometrial tissue, causing infertility, dysmenorrhea, pelvic pain.

Question 16

What are common sites for endometriosis?

Answer 16

Ovary, uterine ligament, rectovaginal septum, pelvic peritoneum.

Question 17

What are macroscopic features of ovarian endometriosis?

Answer 17

Bluish cystic nodules, fibrosis, chocolate cysts.

Question 18

What are microscopic features of ovarian endometriosis?

Answer 18

Endometrial stroma, glands, hemosiderin-laden macrophages.

Question 19

What is the leading cause of gynecologic cancer death?

Answer 19

Ovarian cancer.

Question 20

What are symptoms of ovarian cancer?

Answer 20

Pelvic/abdominal pain, urinary urgency, bloating, early satiety.

Question 21

What are the main types of ovarian cancer?

Answer 21

Epithelial (90%), Sex-cord stromal, Germ cell, Metastasis.

Question 22

What are the two groups of epithelial ovarian cancer?

Answer 22

Type I (indolent) and Type II (aggressive).

Question 23

What are Type I carcinomas associated with?

Answer 23

Endometriosis or borderline serous tumors.

Question 24

What are Type II carcinomas associated with?

Answer 24

High-Grade Serous Carcinoma (HGSC), Undifferentiated carcinoma.

Question 25

What is the most common ovarian cancer type?

Answer 25

High-Grade Serous Carcinoma (HGSC), 70% of cases.

Question 26

What are microscopic features of Low-Grade Serous Carcinoma (LGSC)?

Answer 26

Isolated tumor cells, small glands, micropapillae, psammoma bodies.

Question 27

What are microscopic features of High-Grade Serous Carcinoma (HGSC)?

Answer 27

P53 mutation, cystic, papillary, solid growth, hemorrhage, necrosis.

Question 28

What are the types of Serous Tumors?

Answer 28

Benign (Cystadenoma), Borderline, Malignant (LGSC, HGSC).

Question 29

What is Serous Cystadenoma?

Answer 29

Benign tumor, 4th-5th decades, thin-walled unilocular cyst, clear serous fluid.

Question 30

What is Serous Borderline Tumor?

Answer 30

Short villi, no invasion, peritoneal implants possible.

Question 31

What are Clear Cell Tumors?

Answer 31

Benign (Cystadenoma), Borderline, Malignant (Carcinoma).

Question 32

What is Clear Cell Carcinoma?

Answer 32

Often arises from endometriosis, large unilateral tumors, solid or cystic.

Question 33

What are Endometrioid Tumors?

Answer 33

Benign (Cystadenoma), Borderline, Malignant (Carcinoma).

Question 34

What percentage of Endometrioid Carcinomas are linked to endometriosis?

Answer 34

10%-20%.

Question 35

What is Endometrioid Cystadenoma?

Answer 35

Lined by cuboidal/columnar epithelium, no cytologic atypia.

Question 36

What are Mucinous Tumors?

Answer 36

85% benign, 15% malignant, multilocular cysts, gelatinous fluid.

Question 37

What are Transitional (Brenner) Tumors?

Answer 37

Resemble bladder epithelium, solid or cystic, mostly benign.

Question 38

What is the role of BRCA1 in ovarian cancer?

Answer 38

DNA damage response, checkpoint activation, DNA repair.

Question 39

What is the role of BRCA2 in ovarian cancer?

Answer 39

Mediates homologous recombination.

Question 40

What ovarian cancer is linked to BRCA mutations?

Answer 40

High-Grade Serous Carcinoma (HGSC).

Question 41

What are the microscopic features of Serous Cystadenoma?

Answer 41

Thin-walled unilocular cyst, lined by ciliated cuboidal/columnar epithelium.

Question 42

What are the microscopic features of Serous Borderline Tumor?

Answer 42

Short villi, no invasion, no desmoplasia.

Question 43

What are the microscopic features of Clear Cell Carcinoma?

Answer 43

Tubulocystic, papillary, solid patterns, clear cells, hobnail cells.

Question 44

What are the microscopic features of Endometrioid Carcinoma?

Answer 44

Stratified columnar epithelium, cytologic atypia, mitotic figures.

Question 45

What are the microscopic features of Mucinous Tumors?

Answer 45

Apical mucin-containing endocervical or intestinal epithelium.

Question 46

What are the microscopic features of Transitional (Brenner) Tumors?

Answer 46

Transitional epithelium, fibroblast stroma.

Question 47

What is the most common age for Serous Cystadenoma?

Answer 47

4th and 5th decades.

Question 48

What is the most common age for High-Grade Serous Carcinoma (HGSC)?

Answer 48

6th and 7th decades.

Question 49

What is the most common age for Stromal Hyperthecosis?

Answer 49

6th and 9th decades.

Question 50

What is the most common age for Stromal Hyperplasia?

Answer 50

6th and 7th decades.

Question 51

What is the most common age for Ovarian Fibromatosis?

Answer 51

Mean age 25 years.

Question 52

What is the most common age for Polycystic Ovary Syndrome (PCOS)?

Answer 52

Young, anovulatory women.

Question 53

What is the most common age for Endometriosis?

Answer 53

Reproductive age.

Question 54

What is the most common age for Ovarian Cancer?

Answer 54

Postmenopausal women.

Question 55

What is the most common age for Clear Cell Carcinoma?

Answer 55

Often in women with endometriosis.

Question 56

What is the most common age for Mucinous Tumors?

Answer 56

Varies, but often in reproductive to postmenopausal age.

Question 57

What is the most common age for Transitional (Brenner) Tumors?

Answer 57

Varies, but often in middle-aged women.

Question 58

What is the most common age for Endometrioid Carcinoma?

Answer 58

Often in women with endometriosis.

Question 59

What is the most common age for Low-Grade Serous Carcinoma (LGSC)?

Answer 59

Varies, but often in younger women.