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Fallopian Tubes and Ovaries

Fallopian Tubes
1. Inflammations
  1. Suppurative salpingitis
    1. Gonococcus, Chlamydiae, Tuberculous salpingitis
2. Tumors and Cysts
  1. paratubal cysts
  2. hydatids of Morgagni
  3. adenomatoid tumors (mesotheliomas)
Ovaries
1. Nonneoplastic and Functional Cysts
  1. follicle and luteal cysts
    1. unruptured graafian follicles
  2. Polycystic Ovaries and Stromal Hyperthecosis
    1. hyperandrogenism, menstrual abnormalities, PCOS, chronic anovulation, decreased fertility
    2. many cysts, large follicles
    3. Stromal hyperthecosis
      1. hyperplasia
    4. theca lutein hyperplase of pregnancy
      1. mimics the disease
2. Ovarian Tumors
  1. most spread beyond ovary before detection
  2. come from...
    1. surface/fallopian tube epithelium and endometriosis
    2. germ cells
    3. stromal cells
  3. Epithelium Tumors
    1. arise from mullerian epithelium
    2. Serous Tumors
      1. risk factors: nulliparity, family history, heritable mutations
        reduced by contraceptives or tubal ligations
        BRCA 1 and 2 mutations
      2. low grade
        KRAS, BRAF, ERBB2, wt TP53
      3. high grade
        TP53
        widespread infiltration
      4. Borderline Tumors
        stromal papillae, stratification of epithelium, mild nuclear atypia, no invasion
      5. surface of ovary
    3. Mucinous Tumors
      1. KRAS mutation
      2. larger cystic masses
      3. distinguished from cystadenomas by epithelial stratification.
      4. glandular expansion
      5. pseudomyxoma peritonei
        mucinous ascites
    4. Endometrioid Ovarian Tumors
      1. endometrioid adenofibromas
        benign
        have tubular glands
        mutations in PI3K/AKT and DNA repair, TP53 common
    5. Clear Cell Carcinoma
      1. large epithelial cells with abundant clear cytoplasm
      2. resemble hypersecretory gestational endometrium
    6. Cystadenofibroma
      1. benign, simple papillary processes.
    7. Transitional Cell Tumors
      1. resemble urothelium
    8. Detection
      1. lower abdominal pain or enlargement
      2. generally found in later stages
  4. Germ cell Tumors
    1. Teratomas
      1. Mature
        benign
        dermoid cysts
        have skin like structures
        have mature tissues developed
      2. Monodermal or Specialized
        struma ovarii
        mature thyroid tissue
        unilateral
      3. Immature
        resemble benign tumors
        grow rapidly
        embryonal and fetal tissue
    2. Dysgerminoma
      1. no endocrine function
      2. OCT3, OCT4, NANOG
      3. malignant
        only some are aggressive
    3. Yolk Sac Tumor
      1. alpha fetoprotein
      2. Schiller-Duval Bodies
        glomerulus like structure surround by tumor cells
    4. Choriocarinoma
      1. placental origin
        high levels of chorionic gonadotropins
        unresponsive to chemo
  5. Sex-Cord Stromal Tumors
    1. Granulosa Cell Tumors
      1. resemble ovarian follicle
      2. produce large amounts of estrogen
      3. behave like low grade malignancies
      4. elevated inhibin
    2. Fibromas, Thecomas, Fibrothecomas
      1. fibroblasts or spindle cells
      2. fibromas are unilateral, hard white masses
        pain, ascites, hydrothorax
    3. Sertoli-Leydig Cell Tumors
      1. produce masculinization or defeminization
      2. mutations in DICER1
  6. Metastatic tumors
    1. commonly from mullerian origin

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Fallopian Tubes and Ovaries

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	Created by Jeff Amos about 10 years ago