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Repro / GU > SM_219b: Pathology of Ovary / Fallopian Tubes and Adnexal Mass > Flashcards

SM_219b: Pathology of Ovary / Fallopian Tubes and Adnexal Mass Flashcards

(47 cards)

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1
Q

Primary pathology is in the ___

A

Primary pathology is in the fallopian tube

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2
Q

Describe fallopian tube histology

A

Fallopian tube histology

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3
Q

Inflammatory disorders of fallopian tube are ____, ____, ____, and ____

A

Inflammatory disorders of fallopian tube are

  • Related to PID
  • Acute / suppurative salpingitis: due to Neisseria gonorrhoeae or other bacteria
  • Chronic salpingitis: follows resolution of acute salpingitis, risk of infertility and ectopic pregnancy
  • Hydrosalpinx: dilated tube lumen and flattened lining, usually result of acute / chronic salpingitis, filled with serous fluid
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4
Q

Acute salpingitis appears as ___ on histology

A

Acute salpingitis appears as distended plicae containing acute and chronic inflammatory cells on histology

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5
Q

Chronic salpingitis appears as ___ on histology

A

Chronic salpingitis appears as fused fibrotic plicae creating cyst-like spaces on histology

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6
Q

Hydrosalpinx appears as ____

A

Hydrosalpinx appears as dilated fallopian tube lumen

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7
Q

Risk factors for tubal ectopic pregnancy are ____, ____, and ____

A

Risk factors for tubal ectopic pregnancy are prior ectopic pregnancy, history of tubal sterilization, and history of PID / salpingitis

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8
Q

Ectopic pregnancy appears as ____, ____, and ____ on histology

A

Ectopic pregnancy appears as chorionic villi and fetail tissue within fallopian tube, implantation site in fallopian tube wall, and hematosalpinx on histology

  • Hematosalpinx: dilated fallopian tube containing blood
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9
Q

Paratubal cysts are ____

A

Paratubal cysts are benign cysts lined by different types of epithelium (e.g. mesothelium)

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10
Q

Hydatid of Morgagni is a ___

A

Hydatid of Morgagni is a cyst arising in fimbriated end from Mullerian duct remnants

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11
Q

Leading diangosis is ___

A

Leading diangosis is ectopic pregnancy

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12
Q

Treatment should be ___

A

Treatment should be bilateral salpingo-oophorectomy

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13
Q

Serous tubal intraepithelial carcinoma is ____ and ____

A

Serous tubal intraepithelial carcinoma is the probable origin of most high-grade serous ovarian carcinomas and arise from secretory tubal epithelial cells, usually the fimbriated end

  • Most often found in prophylactically removed specimens from high-risk patients
  • Mutation in p53 (same as corresponding invasive carcinoma)
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14
Q

Describe clinical implications of serous tubal intraepithelial carcinoma

A

Clinical implications of serous tubal intraepithelial carcinoma

  • Remove fallopian tubes along with ovaries in high-risk patients
  • Opportunistic salpingectomy in average-risk women
  • Carefully examine histology of fallopian tubes especially fimbriae
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15
Q

Describe pathology handling of fallopian tubes

A

Pathology handling of fallopian tubes

  • Always submit entire fimbriated end when present
  • High-risk patients: sectioning and extensively examining the fimbriated end (SEE-FIM)
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16
Q

Describe normal histology of the ovary

A

Normal histology of the ovary

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17
Q

Descrube oovarian follicles

A

Oovarian follicles

  • Primordial -> primary -> secondary / preantral -> tertiary / antral -> mature / Graafian
  • General structure: oocyte and surrounding supporting cells (granulosa cells, theca interna, theca externa)
  • After ovulation: corpus luteum (luteinization: accumulation of steroidogenic organelles - smooth ER, mitochondria)
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18
Q

Describe normal histology of the ovarian follicles

A

Normal histology of the ovarian follicles

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19
Q

Describe normal histology of the corpus luteum

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A

Normal histology of the corpus luteum

20
Q

Non-neoplastic disorders of the ovary are ____, ____, and ____

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A

Non-neoplastic disorders of the ovary are follicular / corpus luteal cysts, polcystic ovaries, and endometrial cysts / endometriosis

21
Q

Follicular / corpus luteal cysts are ____ that can ____ and cause ____

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A

Follicular / corpus luteal cysts are dilated follicles filled with clear fluid usually < 2 cm that can rupture and cause peritonitis

22
Q

Polycystic ovarian syndrome causes ____

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A

Polycystic ovarian syndrome causes anovulatory fertility

  • Increased androgens
  • Histologic features are non-specific but include numerous cystic and atretic follicles
23
Q

Describe the major categories of ovarian tumors

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A

Major categories of ovarian tumors

  • Oocytes (germ cells): germ cell tumors
  • Supporting cells of the oocytes (sex cords) and ovarian stroma: sex cord-stromal tumors
  • Fallopian tube, endometriosis, other: epithelial tumors
  • Another origin: metastasis
24
Q

Describe the most common ovarian neoplasms

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A

Ovarian neoplasms

  • Epithelial (65-70%): serous tumors (high-grade carcinoma), mucinous tumors, endometrioid carcinoma, clear cell carcinoma, Brenner tumor
  • Germ cell (15-20%): teratoma, dysgerminoma, yolk sac tumor
  • Sex cord-stromal (5-10%): fibroma / thecome, granulosa cell tumor, Sertoli-Leydig cell tumor
25
Describe general categories of epithelial tumors
General categories of epithelial tumors * Histologic type: serous, mucinous, endometrioid, clear cell, Brenner * Malignant potential: benign, borderline (low), malignant
26
Cystadenomas are \_\_\_\_
Cystadenomas are cystic neoplasm lined by benign epithelial cells * Most common histologic types: serous and mucinous * Mucinous epithelium: resembles endocervical mucinous cells or gastric / intestinal mucinous cells
27
Describe mucinous cystadenoma
Mucinous cystadenoma * Multilocular cyst with smooth lining, can be very large (\> 30 cm), contain mucoid / viscous fluid, usually unilateral * Multiloculated cysts containing mucin
28
Describe borderline epithelial tumors
Borderline epithelial tumors * Atypical proliferative tumor, low malignant potential * Most common histologic types: serous, mucinous * Unusual features intermediate between benign and malignant tumors: extraovarian deposits (implants) in peritoneum or lymph nodes
29
Compare type I and II epithelial carcinomas of the ovary
Type I and II epithelial carcinomas of the ovary
30
Clear cell carcinoma is a \_\_\_
Clear cell carcinoma is a type I epithelial tumor of the ovary (malignant)
31
High-grade serous carcinoma is a ____ epithelial tumor of the ovary
High-grade serous carcinoma is a type II epithelial tumor of the ovary (malignant)
32
Describe high-grade serous carcinoma of ovary
High-grade serous carcinoma of ovary * Most common ovarian carcinoma * Aggressive neoplasm * Almost always presents at high stage (intraperitoneal spread, omental caking) * Most originate from STIC * Histology identical to uterine serous carcinoma
33
Describe clear cell carcinoma of ovary
Clear cell carcinoma of ovary * Originates from endometriosis * High-grade tumor by definition (type I) * Classic histologic feature: hobnailing
34
\_\_\_\_ is characteristic histologic feature of clear cell carcinoma of ovary
Hobnailing is characteristic histologic feature of clear cell carcinoma of ovary
35
Describe germ cell tumors of ovary
Germ cell tumors of ovary * Derived from pluripotent stem cells * Ovarian and testicular germ cell tumors can have same histologic types: different frequencies of each type, sometimes different behavior
36
Teratoma can be ____ or \_\_\_\_
Teratoma can be mature or immature
37
Describe mature teratoma
Mature teratoma * Most common ovarian germ cell tumor * Almost always cystic * Derivatives from multiple germ layers * Benign
38
Describe immature teratoma
Immature teratoma * At least focal immature or embryonal tissue * Malignant tumor: can grow rapidly, metastasize, and recur
39
Yolk sac tumor is a ____ that produces \_\_\_\_
Yolk sac tumor is a malignant germ cell tumor that produces alpha-fetoprotein
40
\_\_\_\_ is pathognomonic finding of yolk sac tumor
Schiller-Duval body is pathognomonic finding of yolk sac tumor
41
Sex cord-stromal tumors are derived from \_\_\_\_
Sex cord-stromal tumors are derived from ovarian stroma / sex cords * Can be purely stromal, purely sex cord, or mix of both
42
Describe fibrothecoma
Fibrothecoma * Benign tumor * Solid, well-circumscribed * Composed of fibroblasts (fibroma) with collagenous stroma and theca cells (thecoma) which are plump spindle cells containing lipid * Occasionally fibroma is associated with Meigs syndrome: ovarian tumor + ascites + hydrothorax
43
Granulosa cell tumor has types of ____ and \_\_\_\_
Granulosa cell tumor has types of adult and juvenile * Adult type: usually postmenopausal patients * Juvenile type: young patients * Adult type much more common
44
Adult granulosa cell tumor classic feature is \_\_\_
Adult granulosa cell tumor classic feature is Call-Exner body * Considered low malignant potential: can metastasize and recur * Produce estrogen: can be associated with endometrial hyperplasia
45
Most common primary sites of metastatic ovarian tumors are \_\_\_\_, \_\_\_\_, and \_\_\_\_
Most common primary sites of metastatic ovarian tumors are gynecologic, GI tract, and breast
46
This is a ____ originating from the \_\_\_\_
This is a high-grade serous carcinoma originating from the fallopian tube
47
This is a \_\_\_
This is a cystadenoma

Repro / GU (46 decks)

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