Pathology Notes

Practice questions IV, female genital tract Pathology of ovary B © Jun Wang, MD, PhD 1. Use this case for the next five questions. A 51-year-old woman presents with vague left lower abdominal pain for 2 months. She denies other symptoms. She has a history of endometriosis that was treated with oral contraceptives. She has multiple squamous cell carcinoma of skin during the past ten years and was treated with local resection. She smokes cigarette 1 pack a day for 25 years and drinks 1 glass of wine per day for 20 years. Physical examination reveals a firm mass at her left adnexa. Image studies reveals a 3.5 cm solid and cystic mass at her left ovary and a 1.2 cm cystic lesion at her right ovary. Bilateral oophorectomy was performed. Microscopically, the right ovarian lesion has tubular gland lined by benign appearing columnar cells with no mucin production. There are signs of old hemorrhage but no cytological atypia is noted. The left ovarian mass has complex gla

Practice questions IV answers, female genital tract Pathology of Ovary B © Jun Wang, MD, PhD 1. B. Tubular glands lined by benign columnar cells without mucin production in a background of endometrioid stroma is consistent with endometrioid tissue. It is endometriosis if found outside uterine cavity. Endometrioid adenocarcinoma has irregular complex endometrioid type glands lined by atypical columnar cells, and commonly has squamous metaplasia, as those in endometrioid endometrial adenocarcinoma . Clear cell carcinoma has either clear cytoplasm or hobnail tumor cells . Both are associated with endometriosis . Squamous carcinoma has irregular nests or cords of atypical cells with squamous differentiation, such as intercellular bridges and/or squamous pearls . Mucinous cystadenocarcinoma has markedly atypical cells with mucinous differentiation. 2. C. See discussion in question 1. 3. C. See discussion in question 1. 4. B. Ovarian endometrioid adenocarcinoma i