Path: female pt 3

what is the most common primary lesion of the fallopian tube?

paratubal cysts

What is this?

causative agent: gonococcus and chlamydiae

suppurative salpingitis

what arises from the epithelium of the fallopian tube?

serous ovarian cancer

What is this?

pelvic pain, adnexal tenderness, fever, and vaginal discharge

pelvic inflammatory disease (PID)

what is this?

tubal plicae adhere to one another, slowly fuse in reparative scarring process

chronic salpingitis

What can chronic salpingitis lead to?

infertility or ectopic pregnancy (scarring of tubal lumen doesn’t allow for proper passage of ovum)

what is this?

inflammation of liver capsule, without involvement of the liver parenchyma, with adhesion formation accompanied by RUQ pain

Fitz-Hughes-Curtis syndrome (chronic manifestation of PID)

what is this?

violin string-like adhesions

Fitz-Hughes-Curtis syndrome (chronic manifestation of PID)

what is Fitz-Hughes-Curtis syndrome?

a chronic manifestation of PID

what is this?

risk factors: chronic salpingitis or IUD

ectopic pregnancy

what is this?

trophoblastic cells and chorionic villi invade the wall of the fallopian tube → growth of gestational sac distends fallopian tube → thinning of the wall and rupture

ectopic pregnancy

what is this?

most common cause of hematosalpinx (blood in the fallopian tubes)

ectopic pregnancy

what is important to remember about extopic pregnancy?

rupture of tubal pregnancy is a medical emergency

what is this?

acute abdominal pain, vaginal bleeding, enlarged right fallopian tube

ectopic pregnancy

what test would we order to confirm a suspected ectopic pregnancy?

hcg

Where does this originate?

nulliparity, ascites, psammoma bodies

surface epithelium (this is a review not from this lecture)

What test would we use to confirm this?

mucin-producing signet ring cancer cells

Krukenberg tumor → gastric biopsy (this is a review not from this lecture)

What is this?

rare mass that forms inside the uterus at the beginning of a pregnancy

hydatidiform mole (molar pregnancy)

what is this?

cystic swelling of chorionic villi and variable trophoblastic proliferation

hydatidiform mole (molar pregnancy)

what is this?

greatly increased HCG serum levels compared to gestational age

complete mole

what is this?

delicate friable mass of thin-walled translucent cystic grapelike structures

hydatidiform mole

what is this?

disproportionately high serum hcg, size-date discrepancy, absent fetal heart sounds, grape like mass in vaginal canal

hydatidiform mole

what is this?

transvaginal US: snowstorm appearance

hydatidiform mole

what karyotype do we expect with a complete mole?

46, XX

What is this?

results from the fertilization of an egg that has lost its female chromosomes (genetic material is completely paternally derived)

complete mole

what is this?

associated with choriocarcinoma; embryo dies very early in development

complete mole

what is this?

results form the fertilization of an egg with two sperm

partial mole

what is this?

not associated with choriocarcinoma; fetal tissue usually present

partial mole

what karyotype do we suspect with partial mole?

triploid 69, XXY

What is this?

malignant neoplasms of trophoblastic cells derived from a previously normal or abnormal pregnancy

choriocarcinoma

what is this?

absent chorionic villi

choriocarcinoma

what is this?

has a high tendency for hematogenous spread; by the time of discovery mets may be widespread (lungs, vagina, brain, liver, bone, etc)

choriocarcinoma

what is this?

HCG levels elevated above moles but ______

choriocarcinoma: NOTE: while levels can be elevated a lot, if the tumor is necrotic then the HCG levels are low

what is important about choriocarcinoma of the uterus

it has excellent response to chemo

What is this?

neoplastic proliferation of intermediate trophoblasts (extravillous trophoblasts); produce human placental lactogen

placental site trophoblastic tumor (PSTT)

what is this?

hist: malignant trophoblast cells diffusely infiltrating the endomyometrium

placental site trophoblastic tumor (PSTT)