Repro Exam 2: Leech Diseases Of The Fallopian Tubes And Ovaries

Front 1

This is a 2 hr lecture :(

Back 1

ok lets have some fun

Front 2

What are 2 inflammations of the fallopian tubes?

Back 2

1. supportive salpingitis

2. Tuberculous salpingitis

Front 3

This inflammation of the fallopian tubes occurs 60% with gonococcus.
It can also occur with chlamydia but less often a factor?

Back 3

Suppurative salpingitis

Front 4

This inflammation of the fallopian tubes is UNCOMMON in the US.
But is a common cause of infertility?

Back 4

Tuberculous salpingitis

Front 5

we need to review some anatomy for understand this is aside shit

Back 5

just look at this

Front 6

salpinx and fallopian tube are the SAME thing

Back 6

Front 7

You need to know where these are located on the fallopian tube:
intramural
isthmus
ampulla
infundibulum

Back 7

Front 8

What do the wall of the fallopian tube look like?

Back 8

wall of the fallopian tube includes an elaborately folded mucosa surrounded by a muscularis

Front 9

What does histology of the ampulla look like?

Back 9

here/mucosa is quite elaborate
and
muscularis is relatively thin

Front 10

What does the histology of the isthmus look like?

Back 10

the mucosa is relatively simple
and
muscularis is quite thick

Front 11

This term describes pus in the fallopian tube?

Back 11

Pyosalpinx

Front 12

This inflammation of the fallopian tube
is due to
Neisseria gonorrhoeae
on slide it is surrounded and infiltrated with numerous neutrophils

Back 12

Acute salpingitis

Front 13

What are the 2 types of cysts you need to know for the fallopian tubes?

Back 13

1. Patatubal
2. Hydatids of Morgagni

Front 14

What cyst of the fallopian tube can be be between 0.1-2.0cm in size?

Back 14

Patatubal

Front 15

What cyst of the fallopian tube can be larger, located near fimbria, and may arise in miillerian duct remnants?

Back 15

Hydatids of Morgagni

Front 16

picture and text of
Patatubal cysts
mine not leech

Back 16

Front 17

The hydatid of Morgagni is a small, unnecessary tissue sac that hangs loosely from the top of the testis in the male and the Fallopian tube in the female.

Mine not leech

Back 17

n female, the vesicular appendage of the epoophoron (hydatid of Morgagni in female) form one or more small pedunculated vesicles in connection with the fimbriae of the uterine tube, or with the broad ligament close to them.

Front 18

What are 2 tumors of the fallopian tubes?

Back 18

1. Adenomatoid tumor
aka
mesothelioma

2. Adenocarcinoma

Front 19

Are tumors common in fallopian tubes?

Back 19

Nope
tumors are rare

Front 20

At what stage are most adenocarcinomas diagnosed?

Back 20

50% stage I at diagnosis

Front 21

What is the survival rate of adenocarcinoma?

Back 21

40% of pts <5 yr survival rate

Front 22

What mutations are associated with adenocarcinoma?

Back 22

BRCA

Front 23

What tumor is this?
the tumor is well circumscribed and has a smooth, white cut surface
is typically 2 cm or less in diameter, circumscribed, firm and gray, white or yellow
rarely bilateral

note gross image

Back 23

Adenomatoid tumor

Front 24

What tumor is this?
smooth muscle hyperplasia
Small glandlike spaces and cysts are lined by cuboidal to flattened cells

note micro image

Back 24

Adenomatoid tumor

Front 25

What tumor is this?
Gross image:
adenocarcinoma fills and distends the lumen of the organ
the cut surface shows a solid or papillary tumor filling the lumen

Back 25

fallopian tube adenocarcinoma

Front 26

What is the characteristic micro slide of adenocarcinomas?

Back 26

complex papillary architecture

Front 27

ends fallopian tunes

Back 27

begin ovaries

Front 28

What are the 2 ovarian cysts that are Non-neoplastic and functional cysts?

Back 28

1. follicular
2. luteal

- these are both considered physiological
- usually <2cm
- may rupture and cause peritoneal rxn

Front 29

What cyst does this describe?
single layer of granulosa cells is resting on a thick theca layer

Back 29

follicular cyst

Front 30

This is a non-neoplastic and functional cyst.
it is 3-6% frequency in reproductive age
the etiology is unknown but insulin mediators?

Back 30

Polycystic ovaries

Front 31

according to leech and humanpath.com what is the etiology of polycystic ovaries?

Back 31

Currently, the underlying etiology of PCOS is widely debated; however, the resulting clinical manifestations are known to be heavily impacted by environmental factors such as diet

Front 32

what is polycystic ovary also called?

Back 32

stein-leventhal syndrome

Front 33

What size are cystic follicles with polycystic ovaries?

Back 33

0.5-1.5cm

ovaries are often 2x nl size

Front 34

If a person is suffering from polycystic ovary disease what may they present with?

Back 34

anovulation
obesity
hirsutism
increased ovarian production of androgens

Front 35

If you see several subcortical cystic follicles what should you think?

Back 35

Polycystic ovaries

Front 36

Why do you have symmetric enlargement of the ovary?

Back 36

cortical stromal hyperplasia manifests as diffuse stromal proliferation

Front 37

This is a non-neoplastic and functional cyst often seen in post menopausal women.
clinically it might present like PCOD?

Back 37

Stromal hyperthecosis

Front 38

How is stromal hyperthecosis similar to PCOD?

Back 38

Stromal hyperthecosis has:
- ovarian stroma hyperplasia
- uniform enlargement of ovaries

Front 39

What is unique about stromal hyperthecosis though?

Back 39

May see severe virilization

Virilization is the process where typical male characteristics become prominent in a female. Characteristics include voice changes, balding, clitoral enlargement, loss of breast shape and increase in muscle mass.

This is NOT seen with PCOD

Front 40

What are the 5 types of ovarian Tumors?

Back 40

1. Surface Epithelial – stromal tumors
2. Sex cord – stromal tumors
3. Germ cell tumors
4. Malignant, Not otherwise specified
5. Metastatic Nonovarian Cancer

Front 41

What is the most common 65-70% type of tumors of the ovary?

Back 41

Surface epithelial cells

Front 42

What age is most affected with surface epithelial cell tumors of the ovary?

Back 42

20+ yrs

Front 43

print slide 26 and 27

Back 43

it may help

Front 44

Derivations of the different ovarian tumors

Back 44

Front 45

These are what leech says for ovary:

12) Clinical for benign ovary problems
13) Clinical for malignant ovary lesions
16) One more thing...by age...who has what...clinical

Back 45

ow mercy me

Front 46

In what age group are most surface epithelial cells tumors likely to occur?

Back 46

20+

Front 47

In what age are most germ cell tumors liklely to arise?

Back 47

0-25 yrs

Front 48

What 2 types of tumors can occur in all ages?

Back 48

sex cord stroma
&
metastasis to ovaries

Front 49

This ovarian tumor:
Arise from the ovarian surface epithelium
Most common form of ovarian tumor

Back 49

Epithelial ovarian tumors****

know this

Front 50

This is the Most common benign ovarian tumor

Back 50

Cystadenoma

Front 51

what will a cystadenoma look like:
Gross
Micro

Back 51

Gross: unilocular, smooth-lined cyst
Micro: simple serous or mucinous lining

Front 52

are epithelial ovarian tumors likely to be malignant?

Back 52

Nope

called borderline tumors
tumors of low malignant potential

Front 53

Most common malignant ovarian tumor

Back 53

Cystadenocarcinoma

arise from epithelial ovarian tumors

Front 54

What does a cystadenocarcinoma look like grossly?

Back 54

Complex multiloculated cyst
Nodular and solid areas

Front 55

What does a cystadenocarcinoma look like on micro slide?

Back 55

- Stratified serous or mucinous lining with tufting
- Papillary structures with psammoma bodies
- Stromal invasion

Front 56

What is our buzzword for cyadenocarcinoma?

Back 56

psammoma bodies

Front 57

What are the hereditary risk factors for epithelial ovarian tumor:
Cystadenocarcinoma?

Back 57

BRCA-1: breast and ovarian cancers

lynch syndrome

Tumor marker: CA125****

Front 58

How do cystadenocarcinoma spread?

Back 58

commonly spreads by seeding the peritoneal cavity

Front 59

When cystadenocarcinoma found?

Back 59

at a late stage with a poor prognosis

Front 60

if you see presence of glistening mucin within cysts what should you think?

Back 60

mucinous cystadenoma

Front 61

What type of cells line mucinous cystadenomas?

Back 61

columnar cell lining

Front 62

What type of tumor is a teratoma?

Back 62

ovarian GERM CELL tumor

Front 63

What type of cyst is a teratoma?

Back 63

dermoid cyst

Front 64

Are teratomas benign or malignant?

Back 64

>95% are benign

Front 65

When do teratomas most likely occur?

Back 65

in the early reproductive years

Front 66

What is present in teratomas?

Back 66

all 3 germ cell layers are present

Front 67

What are the 3 germ cell layers present in a teratoma?

Back 67

1. ectoderm
2. mesoderm
3. endoderm

Front 68

What type of tissue is found in ectoderm?

Back 68

skin, hair, adnexa, and neural tissue

Front 69

What type of tissue is found in mesoderm?

Back 69

bone and cartilage

Front 70

What type of tissue is found in endoderm?

Back 70

thyroid and bronchial tissue

Front 71

If you see on exam:
ovarian cyst containing hair, teeth, and greasy material

Back 71

think teratoma

ovarian germ cell tumor

Front 72

What is preponderant for the stuma ovarii of teratomas?

again these are ovarian germ cell tumors

Back 72

Struma ovarii: preponderance of thyroid tissue

Front 73

What are the complications that can arise from teratomas?

Back 73

Complications
1. Torsion
2. Rupture
3. Malignant transformation (1%): usually squamous cell carcinoma (SCC)

Front 74

What ovarian germ cell tumor is malignant and common in young adults?

Back 74

Dysgerminoma

Front 75

What are risk factors for dysgerminomas?

Back 75

turner syndrome
&
pseudohermaphrodites

Front 76

What do dysgerminomas resemble in males?

Back 76

seminomas

Front 77

This is a ovarian tumor:
a ovarian sex cord stromal tumor

Back 77

Ovarian fibroma

Front 78

What is the most common stromal tumor?

Back 78

Ovarian fibroma

Front 79

What will a ovarian fibroma look like grossly?

Back 79

firm white mass

Front 80

If you find a ovarian fibroma
an ovarian sex cord stromal tumor
and you see:

fibroma + ascities + pleural effusion

What syndrome is this?

Back 80

Meigs syndrome

Front 81

This tumor is composed of plump, differentiated stromal cells with thecal appearance

Back 81

Thecoma-fibroma

Front 82

This is ovarian tumor
Potentially malignant
Estrogen producing tumor****EXAM

Back 82

Granulosa Cell Tumor

Front 83

How can a granulosa tumor present in:
1. Prepubertal age
2. Reproductive age
3. Postmenopausal age

Back 83

Prepuberal → precocious puberty

Reproductive age → irregular menses

Postmenopausal → vaginal bleeding

Front 84

What does a granulosa cell tumor look like grossly?

Back 84

yellow white mass

Front 85

What does a granulosa tumor look like micro?

Back 85

polygonal tumor cells

formation of follicle-like structures (Call Exner bodies)

Front 86

What are complications of granulosa cell tumors?

Back 86

Complications: endometrial hyperplasia and cancer

Front 87

This is an ANDROGEN producing ovarian tumor?

Back 87

Sertoli-Leydig cell tumor (androblastoma)

Front 88

What is the clinical presentation of Sertoli-Leydig cell tumor (androblastoma)

Back 88

virilization

Front 89

What is the complicaiton of a Sertoli-Leydig cell tumor (androblastoma)

Back 89

risk of female
pseudohermaphrodite

Front 90

Where are ovarian tumors most likley to metastasize?

Back 90

Primary sites:
- Breast cancer
- Colon cancer
- Endometrial cancer
- Gastric “signet-ring cell” cancer (Krukenberg tumor)

Front 91

What is a Krukenberg tumor?
just for kicks

Back 91

Gastric “signet-ring cell” cancer (Krukenberg tumor)

seen with ovarian metastasis