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13 Cards in this Set
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Benign follicular cyst
- loose aggregates of granulosa cells - round nuclei with coarsely granular chromatin - mix of viable and pyknotic nuclei - foamy cytoplasm - mitoses - NO cilia, NO mucous (these indicate surface epithelial origin) High estradiol levels (E2 > 20nmol/L) (high in follicular cysts; low in epithelial lesions) Low CEA, CA-125 Follicular cysts are notorious for causing false +FNAs (cellular, mitotically active) Usually solitary; sometimes multiple - multiple follicle cysts more common in juvenile hypothyroidism, PCOS, ovarian hyperstimulation syndrome |
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Corpus luteal cyst
- Isolated luteinized granulosa cells - abundant finely vacuolated cytoplasm - small, intact or pyknotic nuclei |
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Endometriotic cyst
- numerous hemosiderin-laden macrophages - endometrial glandular and stromal cells |
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detached cilia
seen in serous cyst, hydrosalpinx, cystic teratoma the presence of detached cilia excludes follicular cyst |
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Serous cystadenoma
16% of B9 ovarian tumors *high CA-125 in cyst fluid *low CEA *low E2 |
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mucinous cystadenoma
20% of B9 ovarian tumors women of reproductive age *high CEA *low CA-125 *low E2 - mucinous cells (endocervical-like or goblet cells) - cells are isolated or in ribbons, sheets - macrophages - extracellular mucin |
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serous borderline tumor
- Often only sparsely cellular (most of the aspirate is just cyst fluid) - Atypia (usually less pronounced than in serous adenocarcinomas, but can't actually distinguish btwn these on cytology) - Psammoma bodies - branching clusters, twisted sheets and spheres of cells |
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Serous cystadenocarcinoma
- Highly cellular - large, atypical cells in papillary clusters - Marked nuclear atypia - psammoma bodies - many atypical bare nuclei |
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mucinous cystadenocarcinoma
- isolated cells and sheets - columnar mucinous cells with atypia (can be pretty mild) - extracellular mucin can't tell borderline from adeno on cytology (based on invasion!) |
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Endometrioid adenocarcinoma
- numerous isolated cells - strips or crowded glands - palisading - elongated columnar shape - background is usually bloody, with hemosiderin-laden macs |
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Cystic teratoma
most common GCT most common in the reproductive years ~95% of GCTs in adult women are benign cystic teratomas ~1/3 of GCTs in kids are malignant |
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Granulosa cell tumor
Similar to benign granulosa cells... Adult type: 95%, postmenopausal. secrete estrogen - highly cellular. Call-Exner bodies. Rd nuc with grooves. Juvenile type: kids & teens. secrete estrogen. solid. - LACKS NUC GROOVES. only 10% aggressive despite high mits. r/o small cell ca of ovary (same age) IHC: ALPHA-inhibin CD99 calretinin S100 punctate cytokeratin SMA (-)CK7, EMA |
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Most common mets to ovary?
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GU
Colon Stomach (Krukenberg tumor) Breast |