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Female repro PART2
Pathology (2nd year medicine)
| Question | Answer |
|---|---|
| Most common type of ovarian tumor (70% of cases) | SURFACE EPITHELIAL TUMORS |
| SURFACE EPITHELIAL TUMORS Derived from coelomic epithelium that lines the ovary; coelomic epithelium embryologically produces the epithelial lining of the fallopian tube (_1_ cells), endometrium, and endocervix (_2_ cells). | 1. serous 2. mucinous |
| SURFACE EPITHELIAL TUMORS Serous tumors are full of _1_ fluid. Mucinous tumors are full of _2_ fluid. | 1. watery 2. mucus-like |
| SURFACE EPITHELIAL TUMORS Benign tumors (____) are composed of a single cyst with a simple, flat lining; most commonly arise in premenopausal women (30 - 40 years old) | cystadenomas |
| SURFACE EPITHELIAL TUMORS Malignant tumors (____) are composed of complex cysts with a thick, shaggy lining; most commonly arise in postmenopausal women (60-70 years old) | cystadenocarcinomas |
| ____ mutation carriers have an increased risk for serous carcinoma of the ovary and fallopian tube. | BRCA1 |
| Less common subtypes of surface epithelial tumors include _1_ and _2_. | 1. endometrioid tumor 2. Brenner tumor |
| _1_ are composed of endometrial-like glands and are usually malignant. i. May arise from _2_. ii. 15% of endometrioid carcinomas of the ovary are associate | 1. Endometrioid tumors 2. endometriosis |
| 2nd most common type of ovarian tumor (15% of cases) Usually occur in women of reproductive age Tumor subtypes mimic tissues normally produced by germ cells. | GERM CELL TUMORS |
| ___ are composed of bladder-like epithelium and are usually benign. | Brenner tumors |
| ___ is a useful serum marker to monitor treatment response and screen for recurrence of surface epithelial tumors. | CA-125 |
| Germ Cell Tumor Subtypes 1. Fetal tissue- _1_ and embryonal carcinoma 2. Oocytes- _2_ 3. Yolk sac- _3_ 4. Placental tissue- _4_ | 1. cystic teratoma 2. dysgerminoma 3. endodermal sinus tumor 4. choriocarcinoma |
| Malignant tumor that mimics the yolk sac; most common germ cell tumor in children Serum AFP is often elevated. | Endodermal sinus tumor |
| ____1____ Tumor composed oflarge cells with clear cytoplasm and central nuclei (resemble oocytes); most common malignant germ cell tumor Testicular counterpart is called _2_, which is a relatively common germ cell tumor in males. | 1. Dysgerminoma 2. seminoma |
| Endodermal sinus tumor _____ (glomerulus-like structures) are classically seen on histology | Schiller-Duval bodies |
| Most common germ cell tumor in females; bilateral in 10% of cases | Cystic teratoma |
| Cystic tumor composed of fetal tissue derived from two or three embryo logic layers (e.g., skin, hair, bone, cartilage, gut, and thyroid) | Cystic teratoma |
| ~ Malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts; mimics placental tissue, but villi are absent ~ Small, hemorrhagic tumor with early hematogenous spread | Choriocarcinoma |
| Choriocarcinoma High ___ is characteristic (produced by syncytiotrophoblasts); may lead to thecal cysts in the ovary | Beta-hCG |
| Cystic teratoma Benign, but presence of immature tissue (usually neural) or _1_ (usually squamous cell carcinoma of skin) indicates malignant potential. _2_ is a teratoma composed primarily of thyroid tissue. | 1. somatic malignancy 2. Struma ovarii |
| Malignant tumor composed of large primitive cells Aggressive with early metastasis | Embryonal carcinoma |
| Tumors that resemble sex cord-stromal tissues of the ovary | SEX CORD-STROMAL TUMORS |
| SEX CORD-STROMAL TUMORS types - Neoplastic proliferation of granulosa and theca cells - Composed of Sertoli cells that form tubules and Leydig cells (between tubules) with characteristic Reinke crystals - Benign tumor of fibroblasts | Granulosa-theca cell tumor Sertoli-Leydig cell tumor Fibroma |
| _1_ is a metastatic mucinous tumor that involves both ovaries; most commonly due to metastatic gastric carcinoma (diffuse type) ~Bilaterality helps distinguish metastases from _2_ of the ovary, which is usually unilateral. | 1. Krukenberg tumor 2. primary mucinous carcinoma |
| ____ is massive amounts of mucus in the peritoneum. ~Due to a mucinous tumor of the appendix, usually with metastasis to the ovary | Pseudomyxoma peritonei |
| Normal development of the female genital tract proceeds through a series of events involving the primordial germ cells, the Mullerian (_1_) duct, the wolffian (_2_) ducts, and the _3_. | 1. paramesonephric 2. mesonephric 3. urogenital sinus. |
| By birth, the Mullerian ducts have fused to form the _1_, _2_, and _3_, merging with the vaginal squamous mucosa. The mesopnephric ducts regress, but maybe found as a remnant in the ovary, adnexa and cervix ( _4_ ). | 1. fallopian tubes 2. uterus 3. endocervix 4. Gartner duct cyst |
| HERPES SIMPLEX VIRUS During acute infection, virus migrates to the ____ and establishes a latent infection (persist indefinitely) | regional lumbosacral nerve ganglia |
| HERPES SIMPLEX VIRUS ~Antiviral agents: _1_ or _2_- shorten the length of the initial and recurrent symptomatic phase ~Ultimate solution: _3_ | 1. acyclovir 2. famciclovir 3. effective vaccine |
| MOLLUSCUM CONTAGIOSUM Skin and mucosal lesion caused by _1_. 4 types: MCV 1- 4 ~ MCV 1- most _2_ type ~ MCV 2- most often _3_ | 1. poxvirus 2. prevalent 3. sexually transmitted |
| Infected patients maybe asymptomatic or may complain of yellow, frothy vaginal discharge, vulvovaginal discomfort, dysuria (painful urination), and dyspareunia (painful intercourse). | TRICHOMONAS VAGINALIS |
| Most common complication of gonorrhea in women | PELVIC INFLAMMATORY DISEASE |
| Cytopathic Changes: Multinucleated squamous Cells containing eosinophilic to basophilic viral inclusions with a “ground-glass” appearance. | HERPES SIMPLEX VIRUS |
| Chronic endometritis occurs in association with the following disorders: | • Chronic pelvic inflammatory disease (PID) • Retained gestational tissue, postpartum or postabortion • Intrauterine contraceptive devices • Tuberculosis, either from miliary spread or, more often, from drainage of tuberculous salpingitis. |
| Pelvic inflammatory disease Gonococcal infection is characterized by marked acute inflammation of involved _1_. Smears of the inflammatory exudate disclose phagocytosed gram-_2_ _3_ within neutrophils; | 1. mucosal surfaces 2. negative 3. diplococci |
| Pelvic inflammatory disease Collections of pus may accumulate within the ovary and tube (_1_) or tubal lumen (_2_) | 1. tubo-ovarian abscesses 2. pyosalpinx |
| As compared to gonococcal infections, PID caused by _1_, _2_, and the other puerperal invaders tends to show less involvement of the mucosa and the tube lumen, and more inflammation within the _3_. | 1. staphylococci 2. streptococci 3. deeper tissue layers |
| Staphylococci, streptococci, and the other puerperal invaders often spread throughout the wall to involve the _1_ and the _2_, _3_, and _4_. | 1. serosa 2. broad ligaments 3. pelvic structures 4. peritoneum |
| manifest as opaque, white, scaly plaque-like mucosal thickening and are often accompanied by pruritus and scaling. | LEUKOPLAKIA- |
| Lichen Sclerosus aka | Chronic Atrophic Vulvitis |
| Squamous Cell Hyperplasia previously termed as: | ~hyperplastic dystrophy ~lichen simplex chronicus |
| BENIGN EXOPHYTIC LESIONS Wart-like lesions: 1. _____- induced lesion (Genital wart) 2. _________________ Both sexually transmitted infections _3_/skin tags | 1. Papillomavirus 2. Syphilitic condyloma latum 3. Fibro epithelial polyps |
| Benign, raised or wart like condition of the vulva Agent: Low oncogenic risk HPVs: Types 6 and 11 Histologic examination: papillary, exophytic, treelike cores of stroma covered by thickened squamous epithelium | Condyloma Acuminatum |
| Condyloma Acuminatum Koilocytic atypia: Nuclear _1_, _2_ and cytoplasmic _3_. | 1. enlargement 2. hyperchromasia 3. perinuclear Halo |
| Condyloma Acuminatum aka _____, caused by ____ | genital wart HPV |
| TRUE or FALSE Condylomata acuminata are precancerous lesions. | FALSE Condylomata acuminata are not precancerous lesions. |
| Like the breast, the vulva contains _1_. Presumably because of these “breastlike” features, the vulva may be involved by two tumors with counterparts in the breast. 2a. _____ 2b. _____ | 1. modified apocrine sweat glands 2a. Papillary Hidradenoma 2b. Extramammary Paget Disease |
| -spontaneous regression of classic VIN has been reported. - the risk to progression to invasive carcinoma is higher in women older than 45 years of age or Immunosuppressed. -Peak age: sixth decade of life | Basaloid and Warty Carcinomas |
| ~it arises from a precursor lesion referred to as differentiated vulvar intraepithelial neoplasia. - high frequency of TP53 mutations in differentiated VIN. - peak age: eight decade | Keratinizing Squamous Cell Carcinomas |
| they have a peak incidence between 6th -7th decade of life Prognosis linked principally to depth of invasion with > 60% mortality for lesions deeper than 1mm | MALIGNANT MELANOMA |
| is an uncommon anomaly that arises from a failure of müllerian duct fusion and is accompanied by a double uterus (uterus didelphys). | SEPTATE, OR DOUBLE VAGINA |
| Bulky, Hemorrhagic and Necrotic mass invading the uterine wall No chorionic villi Abnormal proliferation of cytotrophoblast and syncitiotrophoblast neoplastic cells invading the myometrium | CHORIOCARCINOMA |
| CHORIOCARCINOMA metastasize in the: | lungs, brain, bone marrow and liver |
| Intermediate trophoblast is found in the implantation site and placental membranes May be preceded by normal, spontaneous or h-mole | PLACENTAL SITE TROPHOBLASTIC TUMOR |
| 1. Ranks as the second most common malignant tumor of germ cell origin. 2. Tell me about it using the "Dirty Medicine" mnemonic. | 1. Yolk Sac Tumor 2. Yolk (looks like top view of egg) S - Schiller-Duval bodies A - α-fetoprotein (increased; elaborated by tumor) C - Children (girls and boys) |
| 1. The ovarian counterpart of testicular seminoma. 2. Tell me about it using the "Dirty Medicine" mnemonic. | 1. Dysgerminoma 2. DysGERMANoma German flag has 3 colors: 3 letters always - LDH and hCG |
| Teratomas are divided into three categories: (1) ____ (benign), (2) ___ (malignant), and (3) ___ or highly specialized. | 1. mature 2. immature 3. monodermal |
| Most benign teratomas are cystic and are often referred to as _1_, because they are almost always lined by _2_ structures. | 1. dermoid cysts 2. skin-like |
| These are rare tumors that differ from benign teratomas in that the component tissues resemble embryonal and immature fetal tissue. | Immature Malignant Teratomas |
| The specialized teratomas are a remarkable, rare group of tumors, the most common of which are struma ovarii and carcinoid. | Monodermal or Specialized Teratomas |
| Meigs syndrome/triad: | ~ovarian tumor(fibroma) ~hydrothorax ~ascites |
| These rare, unilateral tumors are comprised of large lipid-laden Leydig cells with distinct borders and characteristic cytoplasmic structures called Reinke crystalloids. | Hilus cell tumors (pure Leydig cell tumors) LeyDIG for crystals |
| Tumors arising in the ovarian stroma that are composed of either fibroblasts (_1_) or plump spindle cells with lipid droplets (_2_) are relatively common and account for about 4% of all ovarian tumors. 3. Mix of both | 1. fibromas 2. thecomas 3. fibrothecomas. |
| The most common malignant Sex Cord-Stromal Tumor They are often hormonally active and are associated with endometrial hyperplasia/cancer. | Granulosa cells tumors |
| Granulosa cells tumors In occasional cases, small, distinctive, glandlike structures filled with an acidophilic material recall immature follicles (___). | Call-Exner bodies "Call Granny Exner" |
| A classic metastatic gastrointestinal carcinoma involving the ovaries is termed ____, characterized by bilateral metastases composed of mucin-producing, signet-ring cancer cells, most often of gastric origin. | Krukenberg tumor |
| The most common metastatic tumors of the ovary are derived from tumors of ___ origin: the uterus, fallopian tube, contralateral ovary, or pelvic peritoneum. | müllerian |
| The most common extra-müllerian tumors metastatic to the ovary are carcinomas of the _1_ and gastrointestinal tract, including colon, stomach, biliary tract, and _2_. | 1. breast 2. pancreas |
| Marked villous enlargement Edema Circumferential trophoblast proliferation | Complete Mole |
| Karyotype of Complete Mole and Partial Mole | Complete Mole - 46,XX[46,XY] Partial Mole - Triploid [69XXY, 69XYY, 69XXX] |
| Atypia in VComplete Mole and Partial Mole | Complete Mole - Often Present Partial Mole - Absent |
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matiNIK
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