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    Pathology of The Adnexa

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    Arnella Hutagalung
    This document summarizes various pathologies that can affect the adnexa, or ovaries and fallopian tubes. It discusses congenital anomalies, infections, cysts, endometriosis, and various benign and malignant tumors. Cysts are common and usually benign, while solid masses are more likely to be cancerous. Some of the major pathologies covered include ectopic pregnancies, ovarian cysts, endometriosis, and ovarian cancers such as serous cystadenocarcinoma. Risk factors for ovarian cancer include nulliparity and family history of breast or ovarian cancer.

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    Pathology of The Adnexa

    Uploaded by

    Arnella Hutagalung
    121 views59 pages
    This document summarizes various pathologies that can affect the adnexa, or ovaries and fallopian tubes. It discusses congenital anomalies, infections, cysts, endometriosis, and various benign and malignant tumors. Cysts are common and usually benign, while solid masses are more likely to be cancerous. Some of the major pathologies covered include ectopic pregnancies, ovarian cysts, endometriosis, and ovarian cancers such as serous cystadenocarcinoma. Risk factors for ovarian cancer include nulliparity and family history of breast or ovarian cancer.

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    Pathology of the Adnexa

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    This document summarizes various pathologies that can affect the adnexa, or ovaries and fallopian tubes. It discusses congenital anomalies, infections, cysts, endometriosis, and various benign and malignant tumors. Cysts are common and usually benign, while solid masses are more likely to be cancerous. Some of the major pathologies covered include ectopic pregnancies, ovarian cysts, endometriosis, and ovarian cancers such as serous cystadenocarcinoma. Risk factors for ovarian cancer include nulliparity and family history of breast or ovarian cancer.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    121 views59 pages

    Pathology of The Adnexa

    Uploaded by

    Arnella Hutagalung
    This document summarizes various pathologies that can affect the adnexa, or ovaries and fallopian tubes. It discusses congenital anomalies, infections, cysts, endometriosis, and various benign and malignant tumors. Cysts are common and usually benign, while solid masses are more likely to be cancerous. Some of the major pathologies covered include ectopic pregnancies, ovarian cysts, endometriosis, and ovarian cancers such as serous cystadenocarcinoma. Risk factors for ovarian cancer include nulliparity and family history of breast or ovarian cancer.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 59

    Pathology of the

    Adnexa
    Dr. Soekimin, SpPA ; dr. Jessy Chrestella, SpPA
    Dept. Patologi Anatomi Fakultas Kedokteran
    Universitas Sumatera Utara
    Medan 2010
    Congenital Anomalies
    Parametritis/Salphingitis
    Ectopic pregnancy
    Hydrosalpinx
    Endometriosis
    Para ovarian cyst
    Carcinoma





    Tubal common.
    implantation allows early
    placental development,
    secretion of hCG, and
    maintainance of the corpus
    luteum.
    Clinically features of a normal
    pregnancy and the embryo
    may also complete the early
    embryonic stages of
    development.
    6
    Inflam/Infections - rare
    Ovarian cysts - common.
    Non-Neoplastic
    Follicular, epithelial, Luteal, etc.
    Polycystic ovary syndrome
    Ovarian Hyperstimulation synd.
    Stromal Hyperplasia*
    Endometriosis
    Neoplasms
    Benign (Cysts)
    Malignant (Solid)
    7
    Serous cystadenoma
    Cystoma
    Papillary cystadenoma serosum
    Surface papilloma
    Serous adenofibroma
    Serous cystadenofibroma
    Pseudomucinous cystadenoma
    Teratoma
    - dermoid cyst
    - Solid teratoma.
    Granulosa cell tumor
    Theca cell tumor
    Arrhenoblastoma
    Adrenal rest tumor
    Dysgerminoma
    Brenner tumor
    Fibroma
    Meigs syndrome
    Sarcoma
    Carcinoma (ad.Carcinoma)
    Metastase carcinoma.
    Cysts Common benign very large.
    Solid rare malignant high mortality.
    5
    th
    common cause of female cancer.
    But carcinomas of the ovaries account for more
    deaths than do cancers of all other female
    malignancies together. (US stat).
    Nulliparity & family history (BRCA) - Risk factor.

    10
    Amenorrhoea, hyperoestrogenism and
    multiple follicular cysts.
    Stromal hyperplasia & anovovulation
    Important cause of infertility,
    Endometrial hyperplasia/Carcinoma.
    Clinical features:
    Acne, alopecia, hirsutism,
    Hypertension,
    Insulin resistance, Type 2 DM.
    Obesity Syndrome X.
    11
    12
    Note: capsule thickening, cystic follicles without ova, thecal hyperplasia.
    Metastases of hyperplastic
    endometrium into ovary.
    Retrograde menstruation
    /Metaplasia.
    Estrogen related.
    Pouch of Douglas, the pelvic
    peritoneum and the ovary -
    'chocolate cysts'.
    Periodic Pain, pelvic
    inflammation, infertility.
    13
    14
    Chocolate
    Cysts
    15
    Chocolate
    Cysts
    Common, produce estrogen.
    80% are benign, cystic, young (20-45)
    20% are Malignant, solid - older (>40)
    6% of all cancers in women.
    50% deaths due to late detection.
    The rule:
    Cystic tumors are commonly benign
    Solid tumors are commonly malignant.
    16
    Less clear than other
    Null parity
    Gonadal Dysgenesis
    Family History
    Ovarian cancer genes
    BRCA1 (17q12) & BRCA2(13q12)
    17
    18
    Classification of
    Ovarian Tumours
    Coelomic mesothelium
    Serous (tubal)
    Mucinous (Cx)
    Endometrioid (End)
    Transitional (UT)
    90% of malignant tumors of ovary
    Morphologically
    Cystic Cystadenomas - Benign
    Solid/cystic Cystadenoma - Borderline.
    Solid Cystadenocarcinoma Malignant.
    19
    Frequently bilateral (30-66%).
    75% benign/bord., 25% malignant.
    One or few cysts, papillary/solid.
    Tall columnar ciliated epithelium.
    Papillary, solid, hemorrhage, necrosis or adhesions
    malignancy.
    Extension to peritoneum bad prog.
    20
    Less common 25%, very large.
    Rarely malignant - 15%.
    Multiloculated, many small cysts.
    Rarely bilateral 5-20%.
    Tall columnar, apical mucin.
    Pseudomyxoma peritonei.
    21
    22
    23
    24
    Borderline / Intermediate grade: note larger papillary growth.
    25
    multiloculated, 24cm cystic
    ovary with attached fallopian
    tube and uterus. benign
    serous cystadenoma.
    26
    Note: papillary growths on inner surface
    27
    Note: Multi-loculated cystic tumor with some cysts showing hemorrhage.
    28
    Cuboidal simple Columnar Mucous
    29
    High grade: note large papillary growth extending and covering the cyst.
    30
    High grade: note large papillary growth extending and covering the cyst.
    31
    32
    33
    High grade: note large papillary growth extending and covering the cyst.
    34
    Infiltration
    Papillary projections
    35
    36
    Solid tumor with atypical cells forming sheets and gland like structures
    without stroma. (back to back arrangement of glands)
    Teratoma
    Benign cystic (dermoid cyst)
    Solid immature
    Monodermal struma ovarii, carcinoid
    Dysgerminoma
    Yolksac tumor
    Mixed germ cell tumor
    37
    38
    39
    40
    41
    42
    Cartilage
    Resp. Epith
    Sweat Gl.
    43
    Sebaceous Gl.
    Thyroid
    M.A.L.T.
    Cyst Lumen
    44
    Black arrow: Stratified squamous Keratinizing epithelium.
    Blue arrow: Abundant sebaceous glands.
    45
    46
    Any type of carcinoma, sarcoma or germ cell malignancy.
    47
    Torsion - infarction, perforation,
    hemoperitoneum, and autoamputation
    Bacterial infection of the cyst
    Perforation - sudden acute abdomen, Slow
    granulomatous peritonitis
    Hemolytic anemia clears after removal.
    <5% malignancy Sq. carcinoma.


    48
    49
    50
    51
    52
    53
    Teenage / young, 2% of ovarian neoplasms.
    1/2 of malignant germ cell neoplasms
    Gonadal dysgenesis risk factor.
    54
    Note the pale brown appearance of the parenchyma, along with some central
    collagenous scar. The gross and microscopic appearance of an ovarian dysgerminoma is
    essentially same as a seminoma of the testis in a male.
    55
    56
    Steroid cell tumour of the ovary. A well-circumscribed benign ovarian stromal
    tumour that caused virilisation in the patient
    57
    Summary
    Thank you

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