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Ovarian Pathology
| Question | Answer |
|---|---|
| Cysts lined with an inner layer of granulosa cells and outer layer of theca internal cells that form during ovulation that are under < 3 cm ? | * cystic follicles |
| Over > 3 cm and over 3 cm WITH Luteinization ? | * follicular cysts .... * + LH = Luteal Cyst |
| Polycystic Ovarian Disease ? | * Numerous cystic follicles or follicle cyst, often associated with oligomenorrhea .... * women have anovulation, obesity, and hirsutism |
| Polycystic Ovarian Disease & Cortical Stromal Hyperplasia Gross Morphology ? | * PCOS = see numerous clear, shiny cysts.... * Cortical = stromal prolif, with no cysts |
| Ovarian Tumors overview ? | * mostly benign and usu in younger women..... * Malignant Ovarian Cancer = less incidence than vaginal/cerival, but when we get it, it is WAY more deadly |
| Surface Epithelial-Stromal Tumor types and basics ? | * based on Differentiaion: Serous - Mucinous - endometrioid ....* and on extent of proliferation: Benign (adenoma), Borderline, and Malignant (adenocarcinoma) |
| Further classified based on cystic and/or fibrous features ? | * cystadenoma /cystadenocarcinoma (with cystic structures) --- cystadenofibroma (cyst and fibrous areas)--- adenofibroma (predominantly fibrous areas) |
| Surface epithelial tumors theory ? | * the derivation of mullerian epithelial tumors is the transformation of coelomic epithelium, which then incorporated into ovarian development and repro. development |
| Serous tumors = ? | * Most common malignant ovarian tumor, BUT most are benign or borderline.... * This is a BILATERAL OVARIAN tumor |
| Malignant Serous Tumors = ? | * Low grade = associated with serous borderline tumor mutations in KRAS and BRAF and RARE p53 mutation....... * High Grade = arise De Novo, mutations in BRCA1 and 2, with a COMMON p53 mutation |
| Reduces risk of Malignant Serous Tumors ? | * women over 40 who have taken oral contraceptives and have undergone tubal ligation have reduced risk |
| Mucinous Tumors ? | * Gross = looks like a dried sponge.... * UNILATERAL and are less common than serous, and happens in middle of life (NOT young).... * Have KRAS Mutations..... * gelatinous fluid... * Cysts are lined by tall, columnar epithelial cells with apical mucin |
| Pseudomyxoma peritonei = ? | * Clinical condition defined by extensive mucinous ascites, cystic epithelial implants on the peritoneal surfaces, adhesions and frequently mucinous tumor involving the ovaries .... * thought to be cause by mucinous.... * |
| If bilat. presentaion of a mucinous tumor = ? | * bilateral presentation of mucinous tumors always requires exclusion of a non-ovarian origin --> Pseudomyxoma Peritonei |
| Endometrioid Tumors ? | * BILATERAL (40%) ...* benign and borderline endometrioid tumors.....* Gross = see solidand cystic areas.... * Histo = Tumor consists of tubular glands bearing a close resemblance to benign or malignant endo. –columnar cells secreting mucous onto surface |
| SUMMARY of Epithelial Cell Tumors ? | * Bilateral = Serous and Endo..... * Uni. = Mucinous..... * Most common is Serous.... * Serous is the only cuboidal epi, the rest are Columnar... * Mucinous = LARGE/MASSIVE Tumor.... * Age Group for all = 20+ yr olds |
| If CA-125 is measured = ? | * most common in serous and endometrioid, but not specific ot bs e Dx off of it, so use other tests..... * We use it once Dx is confirmed to check response to tmt and recurrences |
| Clear Cell Adenocarcinoma = ? | * Rare, but see clear cells, and when we see clear cells = really aggressive.... * Only a 65% - 5-year survival rate..... * associated with endometrioid carcinoma |
| Cystadenofibroma = ? | * Variants in which the fibrous stromal proliferation is more pronounced than that of the columnar lining epithelium ..... * Small and benign... * Can have Endo, Mucinous, and Serous |
| Brenner tumor = ? | * Classified as adenofibroma..... * Epithelial components consists of nests of transitional –type epithelium (epithelial cells resembling those lining the urinary bladder) |
| Teratoma basics ? | * Has a Mature Type = benign (has differentiated).... and Immature = is Malignant |
| Mature (Benign) Teratoma = ? | * see in YOUNG women of reproductive age..... *associated with inflammatory limbic encephalitis ....... * Tumors arise from an ovum after the first meiotic division |
| Immature Malignant Teratomas = ? | * Prepubertal adolescents and young women, mean age (18 yrs) ...... * The Tissue resembles embryonal and immature fetal tissue ..... * Can invade ovarian capsule and mets...* Grade based on % of immature epi found |
| Monodermal or Specialized Teratoma = ? | * Rare & Always UNILATERAL - 2 types ..... * Struma ovarii (most common) = has mature thyroid tissue and can cause hyperthy....* Ovarian carcinoid = from intestinal epithelium in ovary (have serotonin syndrome).....* strumal carcinoid- combo of both |
| Dysgerminoma = ? | * Ovarian counterpart of seminoma of the testis ..... * in 2nd and 3rd decades of womens life .... * Secretes HCG and may have syncitiotrophoblastic giant cells on histologic exam.... * 96% cure rate... * Common in Turners due to gonadal dysgenesis |
| Endodermal Sinus (Yolk Sac) Tumor = ? | * 2nd most common germ cell tumor... * Occurs in KIDS (know this pic.)...... * The tumor is rich in α-fetoprotein and α1 antitrypsin ....* rapidly developing pelvic mass with abdominal pain in children or young women.... * See Schiller-Duval Bodies |
| Choriocarcinoma = ? | * placental origin...* Most are mixed.... * See HIGH levels of HCG... * usu. unresponsive to radiation, and often fatal |
| The 3 Sex Cord-Stromal tumors ? | * Granulosa-theca cell tumors --- Fibromas, thecomas and fibrothecomas --- Sertoli-leydig cell tumors (androblastomas) |
| Granulosa-Theca Cell tumors = ? | * In adults we see more bleeding/spotting and even breast cysts..... *In girls, we see precocious puberty.... * Most occur Postmenopausal women....* SEs are from high estrogen production....* High incidence of recurrence...* Biomarker = High INHIBIN lvls |
| Morphology of Granulosa-Theca Cell Tumors = ? | * Call-Exner Bodies seen in purple slide, which look like flower looking things |
| Tumors arising in the ovarian stroma that are composed of either ? | * Fibroblasts- Fibromas ...... * plump spindle cells with lipid droplets- Thecomas ....... * or maybe Mixed- Fibrothecomas |
| Meigs syndrome = ? | * See: ovarian tumor - pleural effusion - ascites .... * when tumor is removed, effusion and ascites goes away |
| Morphology of Fibroma and Thecoma ? | * solid/spherical, with an intact ovarian serosa |
| Sertoli-Leydig Cell Tumors (Androblastoma) = ? | * In 2nd & 3rd decades..... * Unilat. & may resemble granulosa-theca cell tumors.... * Produce musculinization (the Virulizing Tumor) .....* Gross: looks like a cross section of an orange....* see tubules w/sertoli cells or leydig cells mixed in stroma |
| Metastatic Tumors = ? | * common metastatic tumors in the ovary are derived from tumors of the mullerian origin..... * Most common extramullerian tumors that metastasize to the ovary are carcinomas of breast and GI are pseudomyxoma peritonei and Krukenberg Tumor |
| Krukenberg Tumor and Pseudomyxoma Peritonei = ? | * Pseudomyxoma Peritonei = from appendiceal tumors......... * Krukenberg Tumor = bilateral mets to ovary from GI origin, composed of signet-ring cancer cells (gastric cancer) |
Created by:
thamrick800
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