Anatomy of ovarian tumour disease

2021-05-12 04:37 PM

Tumour is 17cm in diameter, has shell, smooth surface, soft cross-section, gray-white or yellow-white, heterogeneous

Germ cell tumours are the second largest group of ovarian tumours after the conventional adenoma, with a probability of 20% of ovarian tumours. This ratio is in Europe and America, and in Asia and Africa, where the incidence of epithelial tumours is lower, granulomas have a higher incidence. Tumours meet at all ages, from young to old, usually from 10-60 years old. In children and girls, more than 60% of ovarian tumours are granulomas, and one-third of these tumours are malignant. In adults, most granulomas (95%) are benign and are mature epidermal or trachomatous tumours.

Tumour plays with germs

Inverse neoplasms include round, bright cytoplasmic cells that resemble primitive stem cells in shape and in tissue chemistry. Inverse germ tumours have a 1-4% incidence of ovarian cancer. In 80-90% of cases, the tumour is discovered before the age of 30, with an average age of 22 years. The tumour is usually in two ovaries (14% in stage I), but sometimes the tumour on the other ovary is diagnosed only microscopically.

The tumour is dense, firm like flesh, smooth or concave surface, split in half with lobes, white, pink or greyish white cross-section. The average diameter is 15cm.

Micro:

Cells are large, multifaceted hyperplasia to bands or sheaths, between the bands is fibrous stroma with scattered lymphocytes and Langhans macrophages. Nuclear tumour cells, cytoplasm with seeds. There are multiple cytokines (10-30 for a large optical field). Tumour cells contain glycogen and alkaline phosphatase. The tumour usually spreads through the other ovary, into the pelvic region, and into the lymph node.

The prognosis is good according to recent studies, with a 5-year survival rate of 75-90%. If paradoxical tumours have only one ovary and are still in the capsule, the expectation of survival is more than 90% of 5 years, although if only treatment with simple surgery (removal of an ovary and ovary) has 18-52% play. Recurrent tumours are successfully treated with radiation therapy. The prognosis is poor if the tumour has metastasis at the time of diagnosis.

Endodermal sinus tumours

Tumours are second in the germplasmomas. The age of detection is 17 years old, and the tumour is characterized by very rapid growth. According to Kurman, 50% of tumours are detected a week after the first symptoms. 30% of tumours rupture before surgery. The tumour is usually in an ovary, an average of 15cm diameter, has a smooth surface, solid cross-section, or is littered with haemorrhagic necrotic foci. U is yellow or gray.

Micro:

There are many different types, often combined in the same tumour:

The maze form with gaps and catheters that communicate with each other, and is the most common form.

False papillary form with Schiller-Duval bodies.

The polycystic form consists of a stroma with spindle cells and sheaths covered with a layer of mucous epithelium.

The special form, especially the liver form, is difficult to diagnose if the tumour is merely this form. The cells are large, multiply with glandular images. It is common to see round, PAS-positive hyaline bodies. Tumour is positive for alpha-foetoprotein. In one-third of cases, during surgery, the tumour has metastasized into the large connective membrane, lymph nodes and liver. The prognosis is bad if the tumour is large or not completely removed. 93% of tumours recur in the first year, and recurrence is identified by alpha-foetoprotein measurements. Today, with multiple chemotherapies, a 5-year life expectancy is more than 50%.

Embryonic carcinoma

Embryonic carcinoma is a tumour consisting of pluripotent primitive cells, which can be differentiated into:

Embryonic form, like teratogen.

Extrinsic form, such as endodermal sinus tumour or cultured stromal carcinoma.

Tumours account for 4% of malignant germ cell tumours, common in teenagers, with an average age of 15 years. 60% of cases have early puberty. The cyst is usually in one ovary.

General:

Tumour is 17cm in diameter, has a shell, smooth surface, soft cross-section, white gray or yellowish-white, heterogeneous. The tumour has scattered small cysts containing mucus and areas of necrosis and haemorrhage.

Micro:

The tumour consists of large, varied clusters of cells with papillae and glandular slots. U has many mitochondria, over 30 for a large field. Sometimes tumours have hyalin spheres or isolated cytosol. Sparse stromal tissue, oedema and haemorrhage, with sarcomatous embryonic components. In addition to the embryonic composition, there are sometimes mature tissues such as cartilage or parenchyma. Sometimes the tumour has embryonic forms. Cells of the stained embryonic carcinoma were positive for cytokeratin and some alpha-foetoprotein positive, while cytokeratin inverse tumour cells were negative. Malignant high tumour, locally invasive, early metastasis lymphoid, then blood sugar. Tumours are not sensitive to radiation, but the prognosis is better with chemotherapy.

Multiple embryos

Tumours have many embryonic forms, similar to embryos in the early days (before day 18), before the embryo differentiates into 3 leaves, outer leaves, inner and middle leaves. Tumours can be combined with other malignant germ cell tumours. The tumour secretes HCG and alpha-foetoprotein.

Tumours are very rare, occurring in young people or in people of childbearing age.

General:

The tumour is usually in one ovary, usually large in size. Solid tumour, with many necrotic haemorrhagic areas.

Micro:

The tumour is composed of many embryonic forms, with the plate of the embryo, the amniotic fluid and the endoderm, surrounded by the extracellular primitive mesenchymal. Tumour is very malignant, insensitive to radiation. The prognosis is better with chemotherapy.

Buffered carcinoma

Very rare. Ax (1985) recorded only 6 cases. Most ovarian stromal carcinoma is associated with other malignant germ cell tumours such as teratoma or endodermal sinus tumour. Tumours often accompanied by haemorrhage in the abdominal cavity, the tumour is red, brown, fluffy, 4-25cm in diameter.

Micro:

Tumours include cultured cells and cytoplasm. Cells grow polygonal or round, cytoplasmic, dark nucleus. The cytoplasm of culture is large cells with alkaline cytoplasm, containing vacuoles, with many dark coloured nuclei, of irregular size. The tumour has many areas of haemorrhage and less stroma. The tumour secretes HCG. The other ovary may appear luteum (as it did during pregnancy).

The prognosis of buffered carcinoma has changed with chemotherapy. According to Ax, 4 cases of tumours out of 6 cases were alive for another 5 years. Without treatment, the tumour is very malignant, invading neighbouring organs, then spread throughout the abdomen and metastasized in both blood and lymphatic lines. U is insensitive to radiation and insensitive to methotrexate.

Monster tumours

Wrapped mature monster tumours

tumour straps wise g adult tissues including embryos originating from three dollars and structural premature or embryos. Immature teratomas need to be distinguished from malignant mature teratomas, or from mesodermal mixed tumours, which occur in the older population.

tumour straps wise g 1% mature ovarian teratomas. Commonage is 19 years old. In 70% of cases, the tumour has only one ovary. 50% of these teratomas have increased serum alpha-foetoprotein.

General:

The tumour is usually in an ovary, 9-28cm in diameter. Tumour is semi-solid half-wrapped; the cross-section is irregular. The encapsulation area usually contains clear fluid or mucus, or fatty substances.

Micro:

The tumour consists of tissue that comes from all three of the embryonic leaves. Has mature tissue and immature tissue composition. The most common components are neural tissue, with neuroblastoma cells, immature stroma, immature cartilage tissue, digestive epithelium, etc. menstruation:

Grade 0: full of mature tissue.

Grade 1: very little immature tissue, little mitosis. For a long time on a small field, there is young nerve tissue.

Grade 2: more young nerve tissue, more cell division.

Grade 3: much immature nerve tissue. There are more than four small optical fields with immature nerve tissue on a slide. Multiple cell division.

The bigger the tumour, the more likely it is for metastasis.

The 5-year survival prognosis is 83% for degree 1, 51% for degree 2, and 33% for degree 3. In addition to the outer leaf component with nerve tissue, glial tissue, lymphocytes, and neural epithelium has middle leaf components such as fibrous tissue, cartilage, bone, striatum, lymphoid and mesenchymal tissue. The inner leaves are often lined by the columnar epithelium with cilia, or sometimes the respiratory epithelium, the digestive epithelium. The above tissue types are randomly scattered in the tumour but do not tend to arrange the organs as in adult teratomas.

Tumour straps wise g adult children can coordinate with embryonic endoderm sinus tumour, tumour invert the plate, embryonic carcinoma, carcinoma night feeding, and multiple embryos tumour.

Tumours are not sensitive to radiation therapy but sensitive to multiple chemotherapies.

Monster tumour

Condensed growth monster tumour

Also known as a benign mature teratoma. This is a very rare type of ovarian tumour. Tumours are common in children and teenagers. Most solid ovarian tumours have partial embryonic tissue and are classified as malignant. In contrast, dense teratoma consisting of all mature tissue derived from 3 embryonic leaves is benign, with a very good prognosis.

The tumour is usually large, dense in one ovary.

Micro:

Tumours include mature tissues arranged more orderly, tend to arrange into organs. Sometimes the nerve component dominates with the mature nerve tissue and the choroid plexus.

Wrapped mature monster tumours

This is called an epidermal neoplasm. The tumour consists of tissue derived from three embryonic leaves with components derived from the outer leaves predominate. This is the most common type of germ cell tumour, accounting for 5-25% of ovarian tumours.

Tumours can be found at any age but are more common in the reproductive years. Nonspecific clinical symptoms, such as abdominal pain, hypotension, abnormal bleeding, etc.

General:

More than 90% of tumours are less than 15cm in diameter, coated, soft, mobile, smooth shell. The split in the sinuses contains fat similar to residue, and hair. The wall covering the thick, thin, thick place may contain cartilage tissue, teeth, bone tissue, etc.

Micro:

The wrap is usually lined by the skin with the stratified keratinized epithelium, with many follicles, sebaceous glands, and sweat glands. Sometimes the lining is the digestive or respiratory epithelium, sometimes the epithelium lining is removed, and there is a macrophage reaction that eats foreign matter. Tumour tissue may also include brain tissue, neural stromal tissue, retina, nerve ganglion, and vascular plexus. Derived from the middle leaf, there are bones, cartilage, smooth muscle, fibrous and fatty tissue. Derived from the inner leaves are the digestive, respiratory epithelium, glands, thyroid, and salivary glands. The tissue types mentioned above tend to be arranged into organs such as skin, bronchi, intestines, bones, etc.

A fetus in fetus should be differentially diagnosed with a fetus (fetus in fetu). The fetus is located behind the peritoneum, has a spine and limbs, and a developed organ system.

Matured tumours are benign tumours, 8 to 15% of tumours are in two ovaries.

The most common complication of adenocarcinoma is torsion, 16% of adult tumours are twisted, during pregnancy or in the postpartum period. Other rarer complications, such as rupture, infection, immunotypic anaemia and malignancy.

Tumour monster’s mature evil

Maturation tumours are malignant in 2% of cases and are common in the postmenopausal age.

Micro:

The malignant component is usually the stratified epithelium, with typical dendritic carcinoma images. The malignant components can be carcinoid tumours, thyroid carcinomas, basal cell carcinomas, intestinal carcinomas, malignant melanomas, smooth muscle sarcomas and cartilage sarcomas. Usually, u have only one evil ingredient.

The prognosis is bad, only 15-30% survive after 5 years.

Tumours with primarily one type of tissue

Ovarian thyroid tumour or thyroid tumour (Struma ovarii)

Ovarian thyroid tumour is a highly differentiated teratoma, composed entirely or mainly of thyroid tissue. Tumours are rare, accounting for 2.7% of teratomas, and 0.3% of ovarian adenomas. Malignant tumours are rare, with a malignancy rate below 1%.

General:

 has a shell, usually, less than 10cm in diameter, split into a glossy, soft, grey-gold section.

Micro:

The tumour consists of mature thyroid tissue with thyroid follicles of varying sizes, lined by a layer of cylindrical or flattened epithelium. The cysts contain eosinophil, PAS-positive. In malignant degeneration, the thyroid tissue takes the form of follicular or papillary adenocarcinoma, with malformed cells and multiple cells.

Ovarian carcinoids

A highly differentiated teratoma, with a structure similar to carcinoids elsewhere. A rare tumour, less than 1% of ovarian tumour, is common in menopause or after menopause.

The origin of tumours from epidermal-neurons is under debate, as it is possible that the tumour originates from the endoderm of the embryo.

General:

Tumour is usually less than 10cm, sure, uniform cross-section, yellow-brown.

Micro:

the tumour has many forms:

Inverted form: The cells form oases; the cysts are located in the fibrous stroma. Nuclear cells are round, homologous, cytoplasm many. Mitochondria are rare. The sausage contains many orange-brown, silver-loving seeds.

Raised form: Cells are arranged in strips, each raft zigzag, with little alternating stroma.

Mucoid form: The small cysts have high-lined cylindrical cells, with an oval nucleus, the cytoplasm containing a lot of mucins, similar to a sepia.

Carcinoids are often combined with mature tetratomic components (mucous components or parietal epithelium). Inverted carcinoids may be accompanied by an increase in the amount of 5-hydroxy indole acetic acid in the urine in one-third of cases. Tumour also has increased serotonin in serum.

Prognosis is best with raft carcinoids, which usually do not allow metastasis. More malignant, island-type carcinoids are slow-growing and may allow metastasis. Carcinoids are the most malignant, often more metastatic.

Ovarian-carcinoid thyroid tumours

This is a rare type of tumour, consisting of thyroid tissue mixed with raft-like carcinoids. In most cases, the tumour is associated with a solid adult teratoma or with epidermal tumours.

Micro:

Tumours include colloidal thyroid cysts, seen mixed with rafts of carcinoid cells.

The tumour goes well, does not allow metastasis.

Mixed tumour of germ cell

Tumours include germ cell tumours with two or more malignant components derived from the germ cell. Tumours account for 8% of malignant germ cell tumours. The average age is 16 years old.

Tumours have a mean diameter of 10cm, 19% of tumours in both ovaries.

Micro:

81% of tumours have two different tissue components, 14% have three components 2% have four components.

The most common ones are adenocarcinoma (80%), endoderm (70%), immature teratoma (53%), cultured stromal carcinoma (20%), and embryonic carcinoma (13%). 1/3 of these tumours are inverse germ tumours associated with endodermal sinus tumours.

Tumours usually have a diameter of more than 10cm with more than 1/3 of them are endothelial sinus tumours, cystic carcinoma or grade 3 immature teratoma, with poor prognosis.

The prognosis is better when the tumour is less than 10cm in diameter and contains less than 1/3 of the above-mentioned tissue types.

Orogenic tumours

Tumours include components derived from the germ and immature components similar to the cytoplasm or cytoplasm. Tumours often with clear fibrous regression, and are more calcified. Tumour may have Leydig cells.

The tumour is rare, in young people, usually between 20-30 years old.

Tumours are common in genital abnormalities, which may be associated with chromosomal abnormalities such as the 45XO / 46XY mosaic pattern chromosome. Tumours are also often coordinated with inverse germ tumours.

Tumours secrete AFP and HCG. Patients with this tumour often have primary amenorrhea, masculinization and abnormal genital development.

General:

The tumour is usually in the right ovary. 38% of the tumour is in two ovaries. Tumour size is usually several centimetres, with zones of hyalinization and calcification. Solid tumour, yellow or gray cross-section. The uterus is usually small, with or without a fallopian tube.

Micro:

Tumours are nocytes consisting of germ cells and cells derived from the cytosol such as granules or Sertoli cells. In the stroma, there are Leydig cells. Lime bodies are common, and erase the image of the cells or only a little lime in the Call-Exner bodies.

The prognosis is very good. 50% of tumours have inverse germ tumours, the prognosis is better than the pure inverse tumour. Tumour for later metastasis, and less for metastasis.