Pathology (ovarian)

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Pathology (ovarian)
2013-09-07 08:21:18

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  1. How is teratoma classified?
    (1) mature (benign), (2) immature (malignant), and (3) monodermal or highly specialized.
  2. What is the morphology of mature (Benign) Teratomas?
    • 1. unilocular cysts containing hair and cheesy sebaceous material as well as teeth
    • 2. the cyst wall is composed of stratified squamous epithelium with skin adnexal structures
    • 3.About 1% of the dermoids undergo malignant transformation (mc scc)
  3. What is the origin of mature cystic teratoma?
    from an ovum after the first meiotic division
  4. What are the mc monodermal or Specialized Teratomas?
    carcinoid and struma ovary
  5. What are the characteristics of The specialized teratomas?
    • Always unilateral (difference from metastasis)
    • Struma ovarii is composed entirely of mature thyroid tissue which may hyperfunction.
    • The ovarian carcinoid arises from intestinal epithelium in a teratoma, may also be functional, if particularly large (>7 cm).
  6. What are the features of Immature Malignant Teratomas?
    • Component tissues resemble embryonal and immature fetal tissue
    • The higher the neuroepithelium, the higher the grade, the higher the risk of extraovarian extension
    • Seen in prepubertal females (mature seen in reproductive ages)
  7. What is the ovarian counterpart of seminoma?
  8. What are the molecular markers of dysgerminoma?
    • Oct3, Oct4, and Nanog (maintain pleuripotency)
    • c-KIT (receptor tk)
    • HCG (if syncytiotrophoblastic  tissue present)
  9. What is the morphology of dysgerminoma?
    • 1. large vesicular cells having a clear cytoplasm, well-defined cell boundaries, and centrally placed regular nuclei
    • 2. sheets or cords separated by scant fibrous stroma
    • 3. As in the seminoma, the fibrous stroma is infiltrated with mature lymphocytes and occasional granulomas
  10. What is the paraneoplastic syndrome seen in mature cystic benign teratoma?
    Limbic encephalitis
  11. What are the features of Endodermal Sinus (Yolk Sac) Tumor?
    • Similar to the normal yolk sac, the tumor is rich in α-fetoprotein and α1-antitrypsin
    • Its characteristic histologic feature is a glomerulus-like structure composed of a central blood vessel enveloped by germ cells within a space lined by germ cells (Schiller-Duval body)
    • Conspicuous intracellular and extracellular hyaline droplets are present in all tumors, and some of these stain for α-fetoprotein by immunoperoxidase techniques.
    • aggressive
  12. What are features of ovarian choriocarcinoma?
    • Very aggressive
    • Unlike placental counterpart do not respond to chemo
    • Always mixed with other types
    • High HCG levels
  13. Where are the SEX CORD–STROMAL TUMORS derived from?
    ovarian stroma, which in turn is derived from the sex cords (undifferentiated gonadal mesenchyme) of the embryonic gonad
  14. What are the morphological features of Granulosa–Theca Cell Tumors?
    • 1.Tumors that are hormonally active have a yellow coloration to their cut surfaces, due to intracellular lipids. The pure thecomas are solid, firm tumors.
    • 2. small, distinctive, gland-like structures filled with an acidophilic material recall immature follicles (Call-Exner bodies)
    • Positive for inhibin (granulosa component)
  15. What are the clinical features of Granulosa–Theca Cell Tumors?
    • 2/3 in postmenopausal women
    • Granulosa cell tumors have clinical importance for two reasons: (1) their potential to elaborate large amounts of estrogen and (2) the small but distinct hazard of malignancy in the granulosa cell forms
    • precocious puberty, endometrial hyperplasia, cystic disease of the breast, and endometrial carcinoma
    • some may be masculinizing
    • Use inhibin as a marker