Reproductive- Phatology (2) Flashcards
(48 cards)
Ovarian Surface epithelium tumors (benign)
- Serous cystadenoma
- Mucinous cystadenoma
Most common ovarian neoplasm. Lined with fallopian tube–like epithelium. Often bilateral
Multiloculated, large. Lined by mucus-secreting epithelium
Ovarian Surface epithelium tumors (benign)
- Endometrioma
Endometriosis within ovary with cyst formation
pelvic pain, dysmenorrhea, dyspareunia; symptoms may vary with menstrual cycle
“Chocolate cyst”—endometrioma filled with dark, reddish-brown blood. Complex mass on ultrasound.
Ovarian Germ cell tumors (benign)
- Mature cystic teratoma (dermoid cyst)
most common ovarian tumor in females 10–30 years old. Cystic mass containing elements from all 3 germ layers
Can present with pain 2° to ovarian enlargement or torsion
A monodermal form with thyroid tissue (struma ovarii) uncommonly presents with hyperthyroidism
Ovarian Sex cord stromal tumor (benign)
- Fibroma
- Thecoma
Bundles of spindle-shaped fibroblasts. Meigs syndrome—triad of ovarian fibroma, ascites, hydrothorax.
Like granulosa cell tumors, may produce estrogen. Usually presents as abnormal uterine bleeding in a postmenopausal woman.
Ovarian Brenner tumor
Resembles bladder epithelium. Solid tumor that is pale yellow-tan and appears encapsulated. “Coffee bean” nuclei on H&E stain. Usually benign.
Ovarian Surface epithelium tumors (malignant)
- Serous cystadenocarcinoma
-
Most common malignant ovarian neoplasm, frequently bilateral. Psammoma bodies.
Ovarian Surface epithelium tumors (malignant)
- Mucinous cystadenocarcinoma
May be metastatic from appendiceal or other
GI tumors.
Can result in pseudomyxoma peritonei intraperitoneal accumulation of mucinous material.
Germ cell tumors (malignant)
- Dysgerminoma
in adolescents. Equivalent to male seminoma. 1% of all ovarian tumors; 30% of germ cell tumors
Sheets of uniform “fried egg” cells.
hCG, LDH = tumor markers.
Germ cell tumors (malignant)
- Immature teratoma
Commonly diagnosed before age 20. Typically
represented by immature/embryonic-like neural tissue.
Germ cell tumors (malignant)
- Yolk sac tumor (ovarian endodermal sinus tumor)
Aggressive, in ovaries or testes and sacrococcygeal
area in young children. Most common tumor in male infants.
Yellow, friable (hemorrhagic), solid mass. 50% have Schiller-Duval bodies (resemble glomeruli).
AFP = tumor marker.
Sex cord stromal tumors (malignant)
- Granulosa cell tumor
women in their 50s. Produces estrogen and/or progesterone.
Presents with postmenopausal bleeding, sexual precocity (in pre-adolescents), breast tenderness.
Shows Call-Exner bodies (granulosa cells arranged haphazardly around collections of eosinophilic fluid, resembling primordial follicles)
Krukenberg tumor
GI malignancy that metastasizes to ovaries mucin-secreting signet cell adenocarcinoma
Endometrial conditions
Pag. 630
Asherman syndrome
Adhesions and/or fibrosis of the endometrium.
Presents with infertility fertility, recurrent pregnancy
loss, abnormal uterine bleeding, pelvic pain
Endometrial
carcinoma
Most common gynecologic malignancy.
Peak occurrence at 55–65 years old. Presents with
vaginal bleeding
Breast Fibrocystic changes (< 35 years old)
- Sclerosing adenosis
- Epithelial hyperplasia
acini and stromal fibrosis, associated with calcifications. Slight (1.5–2 ×) risk for cancer.
cells in terminal ductal or lobular epithelium. risk of carcinoma with atypical cells.
*premenstrual breast pain or lumps; often bilateral and multifocal
Breast Inflammatory processes
- Fat necrosis
- Lactational mastitis
benign, usually painless, lump due to injury to breast tissue. Calcified oil cyst on mammography; necrotic fat and giant cells on biopsy.
risk of bacterial infection through cracks in nipple. S aureus is most common pathogen
Breast Benign tumors
- Fibroadenoma
< 35 years old. Small, well-defined, mobile mass.
inncrease size and tenderness with estrogen.
Breast Benign tumors
- Intraductal papilloma
small fibroepithelial tumor within lactiferous ducts, typically beneath areola.
Most common cause of nipple discharge (serous or bloody). Slight (1.5–2 ×) risk for cancer
Breast Benign tumors
- Phyllodes tumor
large mass of connective tissue and cysts with “leaf-like” lobulations.
Most common in 5th decade. Some may become malignant.
Gynecomastia
- Causes
Physiologic in newborn, pubertal, and elderly males.
Other causes:
cirrhosis, hypogonadism, testicular tumors, and drugs (Spironolactone, Hormones, Cimetidine, Finasteride, Ketoconazole)
Malignant breast tumors
Usually arise from terminal duct lobular unit.
triple negative (ER ⊝, PR ⊝, and Her2/Neu ⊝) more aggressive
Axillary lymph node involvement indicating metastasis is the most important prognostic factor in early-stage
disease
Non invasive breast cancer
- Ductal carcinoma in situ
- Comedocarcinoma
Fills ductal lumen. Arises from ductal atypia. Often seen early as microcalcifications on mammography.
Ductal, central necrosis. Subtype of DCIS.
Non invasive breast cancer
- Paget disease
Results from underlying DCIS or invasive breast cancer. Eczematous patches on nipple.
Paget cells = intraepithelial adenocarcinoma cells.
