Pathology: Tbl 13: Pregnancy, Ovary And Breast

Front 1

Low grade ovarian tumor, 30% are bilateral, can spread locally via peritoneum, mutations in K-Ras or BRAF oncogene with rare mutation in p53

Back 1

Serous Adenocarcinoma

Front 2

High grade ovarian tumor with mutation in p53, but lacks mutations in K-ras or BRAF, usually arises in women with BRACA 1 or 2, 60% are bilateral, invasive peritoneal spread with rapidly progressive course.

Back 2

Serous Adenocarcinoma (high-grade)

Front 3

Ovarian tumor, occurs in middle-adult life, 80% are benign, commonly have K-ras mutation, characterized by lining with tall columnar epithelial cells

Back 3

Mucinous Tumor

Front 4

This tumor occurs from 40-70 years old, are cystic with solid component, ppl with low parity or BRCA 1 or 2 are at higher risk, stromal invasion, and psammonma bodies.

Back 4

Serous Carcinoma

Front 5

About 30% of tumors, usually in middle life, can be very large, are multilocular with tenacious mucin filling cysts, and smoking is a risk factor.

Back 5

Mucinous Cystadenomas

Front 6

This tumor causes extensive mucinous ascites with cystic epithelial implants on peritoneal surfaces, appendix is source.

Back 6

Pseudomyxomatous Peritonei

Front 7

This timor may coexist with endometriosis, or endometrial hyperplasia/carcinoma. 40% are bilateral. Commonly have mutations in PTEN and K-ras.

Back 7

Endometriod Tumor

Front 8

This tumor is considered a variant of endometrioid carcinoma, of mullerian origin, 40% bilateral, has hobnail cell.

Back 8

Clear Cell Adenocarcinoma

Front 9

Tumor characterized by large epithelial cells with abundant clear cytoplasm similar to hypersecretory gestational endometrium.

Back 9

Clear cell adenocarcinoma

Front 10

This is a solid tumor composed of epithelial cells resembling those of the urinary tract (transitional cells). Usually found incidently, 6% are bilateral.

Back 10

Brenner Tumor

Front 11

Adenofibroma in which the epithelial component consists of nests of transitional-type epithelial cells. Has Walthard rests, usually benign.

Back 11

Brenner Tumor

Front 12

Cystic tumor containing sebaceous material and hair. Are all XX and benign. Are bilateral in 15% of cases. Often present with abdominal or pelvic pain. Has glands, hair shafts, skin, teeth and other adnexal structures.

Back 12

Mature Teratoma

Front 13

This rare tumor is composed of embryonal and immature fetal tissue. It is usually found in prepubertal young women, often presents with abdominal or pelvic pain, has neuroepithelium. Carries risk for subsequent malignant extra-ovarian spread.

Back 13

Immature teratoma

Front 14

This monodermal teratoma has thyroid tissue and may be associated with papillary thyroid carcinoma

Back 14

Monodermal Teratoma

Front 15

Tumor contains primitive neuroepithelium and usually presents in the 2nd decade of life.

Back 15

Immature malignant teratoma

Front 16

Primordial germ cell tumor, has fibrous septa with lymphocytes, responsive to chemotherapy, may occur in patients with gonadal dygenesis, may have elevated levels of chorionic gonadotropin and syncytiotrophoblastic giant cells.

Back 16

Dysgerminoma

Front 17

Expresses Oct3, Oct4, and c-KIT

Back 17

Dysgerminoma

Front 18

Germ cell tumor with reticular arrangement of primitive round cells with papillary structures. Rich in AFP and alpha 1 -antitrypsin. Most patients are children or young women with pelvic pain and rapidly developing pelvic mass.

Back 18

Yolk Sac tumor

Front 19

This germ cell tumor has a chacteristic glomerulus-like structure composed of a central blood vessel enveloped by germ cells (schiller Duval bodies). Usually appear in a single ovary but grow rapidly and aggressively.

Back 19

Yolk Sac tumor

Front 20

The ovarian primary tumors are aggressive and generally metastasize widely through the bloodstream to the lungs, liver, bone etc. Composed of malignant placental-like tissue. Have high levels of HCG. Usually exist in combination with other germ cell tumors.

Back 20

Choriocarcinoma

Front 21

This tumor is solid, spherical, or slightly lobulated, encapsulated, and associated with right hydrothorax and ascites

Back 21

Fibroma

Front 22

Composed of well-differentiated fibroblasts and interspersed collagenous tissue with focal areas of thecal differentiation.

Back 22

Fibroma

Front 23

Triad consisting of ovarian tumor, right hydrothorax, and ascites.

Back 23

Meig's Syndrome

Front 24

These tumors are potentially malignant, cause virilization, occur in 2nd and 3rd decades, are unilateral, and have crystals of reinke.

Back 24

Sertoli-Leydig cell tumors

Front 25

Systemic syndrome characterized by widespread maternal endothelial dysfunction, usually occurs in the last trimester of pregnancy and is caused by placental ischemia due to impaired vasodilation- causes maternal hypertension

Back 25

Preeclampsia

Front 26

Presents in pregnant women with hypertension, proteinuria and edema

Back 26

Preeclampsia- if seizures are present it is eclampsia

Front 27

This is a life-threatening obstetric complication usually associated with preeclampsia, characterized by hemolytic anemia, elevated liver enzymes, and low platelets. May preceed DIC

Back 27

HELLP Syndrome

Front 28

This complication of pregnancy will have elevated fibrin degradation products and elevated lactate dehydrogenase (marker for hemolysis)

Back 28

HELLP Syndrome

Front 29

This condition is characterized by abnormal vaginal bleeding, honeycombed and abnormally enlarged uterus, and a snowstorm appearance on sonogram.

Back 29

Complete Hyatidaform Mole

Front 30

This condition has cystic swelling of chorionic villi and proliferation of chorionic epithelium, is the most common precursor of choriocarcinoma and has highly elevated hCG levels.

Back 30

Complete Hyatidaform Mole

Front 31

This condition is a cystic swelling of chorionic villi and epihelium that has some fetal parts and abnormal placental tissue

Back 31

Incomplete Hyatidaform Mole

Front 32

Occurs during the first month of breast feeding, associated with staph or strep infection, breasts are erythematous and painful. In the beginning, only one duct system or sector of the breast is involved

Back 32

Acute mastitis

Front 33

This nonproliferative change in the breast causes a lumpy, bumpy feel that causes the breast to appear dense with cysts on radiography.

Back 33

Fibrocystic breast change

Front 34

Has three characteristics
1. Cystic change with apocrine metaplasia
2. Fibrosis
3. Adenosis

Back 34

Fibrocystic Breast Change

Front 35

A benign condition that produces an excess of tissue growth in the lobules of the breast

Back 35

Sclerosing Adenosis

Front 36

This condition causes multiple, small, firm tender lumps in the breast. Presents with recurring pain that tends to be linked to the menstrual cycle. Can be seen as a radiologic density or calcification.

Back 36

Sclerosing Adenosis

Front 37

On histologic examination, this condition causes doubling of the acini in the ducts with prominent myoepithelial cells.

Back 37

Sclerosing Adenosis

Front 38

This is the most common benign tumor of the breast, occurs in the 20s and 30s, are multiple and bilateral, and usually presents with a palpable mass in younger women and a mammographic density/calcification in older women

Back 38

Fibroadenoma

Front 39

This breast tumor grows as spherical nodules that are usually sharply circumscribed and freely movable.

Back 39

Fibroadenoma

Front 40

This breast tumor is most common in women in their 40s or 50s. Typically presents with a palpable, firm mass that can increase significantly in size in just a few weeks. It is distinguished from fibroadenomas by its cellularity, mitotic rate, nuclear polymorphism, stromal overgrowth and infiltrative borders.

Back 40

Phylloides Tumor

Front 41

This is an extension of ductal carcinoma in situ into lactiferous ducts and skin of the nipple.

Back 41

Paget's Disease of the Breast

Front 42

Presents with scaling red rash similar to eczema that starts at the nipple and spreads to include the areola with nipple retraction - ductal carcinoma in situ that spreads along duct to the external skin

Back 42

Paget's Disease of the Breast

Front 43

Erythematous breast with dimpling like an orange due to fixed openings of the sweat glands. The underlying carcinoma is usually diffusely infiltrative and typically doesn't form a discrete palpable mass

Back 43

Inflammatory Breast Carcinoma

Front 44

This condition is often associated with either ovarian or adrenal tumor. The principle features are obesity, anovulation or amenorrhea, acne and hirsutism. Gynocologic u/s looks for small ovarian follicles and may have thickened, white smooth outer surface of the ovary

Back 44

Polycystic ovarian syndrome

Front 45

This condition is characterized by an ovarian tumor with ascites and pleural effusion. Has elevated CA-125 tumor marker

Back 45

Meigs Syndrome

Front 46

This is an uncommon tumor commonly associated with cancer of the appendix. Known for its production of mucus in the abdominal cavity that rarely spreads through the abdominal cavity. Its characterized by mucin and scattered cancer cells in the abdomen but not in the liver or other sites of mets.

Back 46

Psuedomyxoma Peritoneri

Front 47

This condition is associated with abdominal pain and distension, digestive disorders and diagnosis is confirmed by cystic epithelial implants on the peritoneal surfaces, adhesions, and frequently mucinous tumors of the ovaries,

Back 47

Psuedomyxoma Peritoneri

Front 48

Syndrome includes flushing and diarhhea, heart failure and bronchoconstriction. The most useful initial test is the 24 hour urine levels of 5-hydroxyindolacetic acid (a product of serotonin metabolism)

Back 48

Carcinoid Syndrome

Front 49

Rare form of mature teratoma that contains mostly thyroid tissue- leads to hyperthyroidism and are usually benign. Immunohistochemical staining for thyroglobulin

Back 49

Struma Ovarii

Front 50

Metastatic ovarian malignancy whose primary site arose in the GI tract or breast. Has signet ring cells. Patient presents with abdominal pain, bloating, vaginal bleeding, and pain during intercourse.

Back 50

Krukenberg Tumor