Neoplastic Ovarian Lesions Research Articles

Differences in Stromal Immunostaining of Tumour Necrosis Factor-alpha and its Receptors in Neoplastic and Non Neoplastic Ovarian Lesions: A Cross-sectional Study

Introduction: Ovarian cancer has an unknown pathogenesis, and cytokines may play an important role in the aetiology and prognosis. Tumour Necrosis Factor-alpha (TNF-α) and its receptors (TNFR1 and TNFR2) are involved in the biology of ovarian cancer, tumour pathogenesis, and their relationship with prognostic factors. They are involved in biological processes such as immunoregulation, growth modulation, and cell differentiation. Aim: To evaluate stromal immunostaining of TNF-α and its receptors (TNFR1 and TNFR2) in malignant ovarian neoplasms, comparing it with benign ovarian neoplasms and non neoplastic ovarian lesions. Materials and Methods: A cross-sectional study was carried out at the Department of Gynaecology and Obstetrics, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil, from January 1997 to December 2020. Patients with ovarian lesions who underwent surgical treatment according to preestablished criteria (n=95) were included in the study. Patients with benign (n=37) and malignant (n=43) ovarian epithelial neoplasms, and non neoplastic ovarian lesions (n=15) were included. Data evaluated included age, parity, hormonal status (menarche or menopause), histological grade, and staging. Immunohistochemical study was performed to evaluate stromal TNF-α, TNFR1, and TNFR2. Data were analysed by GraphPad Prism 6 and IBM Statistical Package for the Social Sciences (SPSS) Statistics 20.0 software. The comparison between non neoplastic tumours, benign and malignant neoplasms was performed by the Fisher’s exact test with a significance level below 0.05. Results: Considering staining intensity 0 and 1 as “weak immunostaining” and 2 and 3 as “strong immunostaining,” TNF-α stromal immunostaining was stronger (2/3) in benign ovarian neoplasms compared to non neoplastic tumours (p-value=0.0016) and in malignant neoplasms compared to non neoplastic tumours (p-value<0.0001). TNFR1 immunostaining was stronger (2/3) in the stroma of malignant neoplasms compared to benign neoplasms (p-value<0.0001) and stronger (2/3) when comparing benign neoplasms with non neoplastic ovarian lesions (p-value=0.0002). For TNFR2, stromal immunostaining was stronger (2/3) in malignant neoplasms compared to benign neoplasms (p-value =0.0091) and stronger in malignant neoplasms compared to non neoplastic lesions (p-value=0.0004). Conclusion: A stronger immunostaining for TNF-α and its receptors was found in ovarian cancer, suggesting that they may be targets for further studies to verify their role in carcinogenesis and the progression of ovarian neoplasms. A better understanding of the role of TNF-α and its receptors in the tumour stroma of ovarian tumours may lead to future studies that may clarify the mechanisms of carcinogenesis and tumour progression.

Histomorphological Study of Different Ovarian Lessons in a Tertiary Care Hospital

Objective: The present study is to ascertain the relative frequency, histologic types, and age distribution of both neoplastic and non–neoplastic ovarian lesions in the Rajshahi medical college hospitals and compare the results with similar studies in other regions of this country and abroad.
 Methods & Materials: This cross-sectional study was conducted in the Department of Pathology, Rajshahi Medical College, over one year from January 2021 to December 2021. A total of 144 cases of ovarian lesions were included in this study. Inflammatory conditions and developmental anomalies were excluded.
 Result: Out of 144 cases of ovarian masses studied, 104 (72%) were neoplastic. The common types were Surface epithelial tumors (70%), germ cell tumors (23%), and sex-cord stromal tumors (7%). The age range of ovarian tumors was 5 to 70 yrs, and the highest incidence was between 21-50 yrs. Most of the ovarian tumors were bilateral (85%).
 Conclusion: Varying types of both non-neoplastic and neoplastic ovarian lesions were seen. Benign tumors were more common than malignant tumors in all age groups. Surface epithelial cell tumors, followed by germ cell tumors, were the most common tumor. Serous cystadenoma was the most common tumor. Tumour types varied in different age groups.
 TAJ 2022; 36: No-1: 17-22

OncoTherad immunotherapy plus platelet rich plasma as potential therapeutic strategy for ovarian cancer: The role of toll-like receptors 2 and 4 signaling pathways.

e17602 Background: Ovarian cancer (OC) has the most devastating death rate of gynecological cancers with only 44% of women surviving 5 years after diagnosis. Toll-like receptors (TLRs) signaling can play an important role in the OC treatment. TLR activation in immune cells can help activate an effective antitumor response. In this scenario, a new perspective is represented by combined OncoTherad (MRB-CFI-1) immunotherapy and Platelet Rich Plasma (PRP). OncoTherad (MRB-CFI-1) leads to the distinct stimulation of the innate immune system mediated by TLR2 and TLR4, resulting in an increased activation of the IFN signaling pathway. Also, PRP acts on immune activation and exerts antitumor effects. This study characterized the histopathological and molecular effects of the OncoTherad associated with PRP in the treatment of OC chemically induced in rats and described the possible mechanisms of action of this association involving the TLRs 2 and 4 signaling pathways. Methods: Fischer 344 female rats were divided into 5 groups (n = 7 animals per group): Control (Sham surgery) group; Cancer (7,12 dimethylbenzoanthracene – DMBA injection in the ovarian bursa, 1.25 mg/kg) group; OncoTherad (20mg/kg) group; PRP (328.103 – 549.103 platelets/mm3) group and; OncoTherad+PRP (same doses of the isolated treatments) group. Intraperitoneal doses were administered twice a week for 4 weeks. Immunohistochemistry was analyzed as total immunoreactivity and intensity of immunoreaction. Results: Our results showed serous type ovarian carcinoma, follicular atresia, absence of corpora lutea and hyperplasia of the germinal epithelium and tunica albuginea in the Cancer group. The histopathological changes in the PRP group were similar as Cancer group. In contrast, the animals treated with OncoTherad singly or in combination with PRP showed decrease of ovarian neoplastic lesions and histopathological recovery. TLR4 and IL-6 immunoreactivities were significantly lower (p < 0.05) in the Cancer group. PRP treatment reduced (p < 0.05) TLR2. In the Oncotherad+PRP group, the immunoreactivities of TLR4, MyD88, IRF-3 and TNF-α were lower. OncoTherad treatment alone led to stimulation of the innate immune system mediated by TLR2 and TLR4, resulting in an increased activation of the MyD88 signaling pathway (intensified IL-6 and TNF-α immunoreactivities). Conclusions: OncoTherad immunotherapy was able to reduce ovarian lesions and stimulated the TLR2 and 4 signaling pathways in the OC microenvironment, leading to antitumor effects by activating the production of inflammatory cytokines. Thus, OncoTherad immunotherapy could be considered an important therapeutic strategy for OC.

Issues and Challenges in Diagnoses of Borderline Ovarian Neoplasms by Frozen Section

Introduction: Frozen section is a rapid intraoperative method of tissue sectioning with the help of cryostat to arrive at a diagnosis and guide the operative procedure. It is an important diagnostic tool in the intraoperative management of ovarian neoplasms. Aims and Objectives: 1) To evaluate clinically suspected ovarian neoplastic lesions by frozen section. 2) To analyze the factors associated with difficulty in diagnoses of borderline ovarian neoplasms. Materials and Methods: This is a cross-sectional study conducted in the Department of Pathology for a period of 2 years. 60 cases of ovarian neoplasms undergoing Frozen section and subsequent histopathological examination are included in the study. Results: The mean age of patient is 39.49 years (21-72). Of the 60 cases, 73.33% are benign, 8.33% borderline and 18.3% are malignant on histopathological diagnosis. The concordance rate of frozen section with histopathological diagnosis is 91.67%. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Frozen section in the diagnosis of Benign, Borderline and Malignant ovarian neoplasms are 95.45%, 92.73%, 97.67%, 88.24% and 88.64%; 100%, 92.16%, 55.56%, 100% and 55.56%; 72.73%, 100%, 100%, 94.23% and 72.73% respectively. Conclusion: Frozen section of ovarian neoplasms helps to arrive at a diagnosis of whether they are benign or malignant with a high level of accuracy. Diagnosis of a benign lesion in a young patient guides the surgeon to a fertility conserving surgery. Likewise, diagnosis of a malignant lesion on table guides the surgeon to execute an extensive surgery in a single setting, saving the patient of the physical, emotional, psychological and financial strain of a second look operation.

Study of histopathological spectrum of ovarian lesions

Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable. In order to have a better understanding of frequency and histomorphological patterns of different ovarian lesions study was encountered in our tertiary care hospital.To study the histopathology of ovarian non-neoplastic and neoplastic lesions and to study the distribution of ovarian lesions with respect to various parameters like age, bilaterality, gross and microscopic features.This is a prospective study of 125 ovarian specimens received in department of pathology, G.K. General Hospital, Bhuj during August 1, 2018 to July 31, 2020. Total 125 cases of ovarian specimens were studied, amongst them 58 were non-neoplastic and remaining 67 were neoplastic. The most common non-neoplastic lesion seen was follicular cysts 12 cases (21%), followed by endometriosis 9 cases (16%). Among 67 neoplastic ovarian lesions 58(87%) cases were benign, 3(4%) cases were borderline and 6 (9%) cases were malignant. In benign ovarian neoplasm, most commonly seen lesions were serous cystadenoma 24 cases (36%) followed by 13 cases (20%) of mature cystic teratoma. In malignant cases, maximum was of high-grade serous cystadenocarcinoma.Ovarian epithelial tumours are the most common type, while serous cystadenocarcinoma was the most common malignancy. Histological examination is gold standard and in certain difficult cases require immunohistochemistry.Ovary is an important reproductive organ with involvement in production of progeny.Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. Ovarian neoplasms have become increasingly important not only because of the wide range of neoplasms, but also because they have gradually increased the mortality rate. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable.

Frequency of Overweight Women and Ovarian Enlargement among Females Presented with Pelvic Pain Complains

Objective: To determine the frequency of overweight females and ovarian enlargement among women presenting with pelvic pain complaints at rural Health facilities of district Tando Muhammad Khan.
 Methodology: This descriptive study was conducted at physiology department of Sindh University with the collaboration of different rural health facilities of Tando Muhammad Khan, Sindh. All the females presented with pelvic pain and age more than 18 and up to 45 years were included. Body mass index (BMI) was assessed by the ratio of the individual's weight in kilograms divided by the height in meters squared (BMI = kg/m2). All the patients underwent ultrasound examination. Data collection was done by structured study proforma. Analysis of the data was done by the SPSS version 20.
 Results: A total of 239 women with pelvic pain complaints were studied, their mean age was 32.79+4.31 years. Neoplastic ovarian lesions were seen amogn12.54% of the cases. Cystic ovarian lesions were among 30.54% of the females, 5.01% had ovarian mass and 21.33% females had mixed pathologies. BMI was normal among 62.76% cases, while 20.08% women were overweight, 03.34% were obese and 13.8%females were underweight.
 Conclusion: Overweight females and ovarian enlargement were observed to be highly frequent among females presented with pelvic pain complaints. Cystic enlargement was observed to be the commonest cause of ovarian enlargement.

An Overview on Etiology, Diagnosis and Management of Ovarian Dermoied Cyst: Simple Review Article

The most common neoplastic ovarian lesions in teens are mature cystic teratomas (MCTs) or dermoid cysts. Little is known about the cause of dermoid cysts. Elevated levels of estrogen and progesterone have been suggested to stimulate the sebum components of these tumors, which may explain why MCTs grow after puberty and stop growing after menopause. MCTs are often asymptomatic and are randomly identified during examination or diagnostic imaging. MCTs show a special appearance during ultrasonography. Most studies suggest that most ovarian dermoid cysts can be successfully treated surgically using laparoscopic surgery. Reduced adhesion formation is one of the benefits of laparoscopic treatment for dermoid cysts. Studies also suggest that laparoscopy causes less blood loss. Less hospitalization and less postoperative pain. And there are fewer postoperative problems than the laparotomy approach. In this article, we will look at the etiology, diagnosis, and treatment of dermoid cysts in the ovary.

HISTOPATHOLOGICAL SPECTRUM OF OVARIAN TUMORS : 5 YEARS RETROSPECTIVE STUDY IN A TERTIARY REFERRAL HOSPITAL IN ASSAM

Introduction : Ovarian tumor accounts for 30% of female genital tract cancers and comprises of large variety of neoplastic entities. Mortality rate has due to ovarian tumor has gradually increased. The present study was undertaken to study the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumors. Methods: Retrospective study was carried during period of 1st January 2015 to 31st st December 2019, 455 cases of ovarian neoplastic lesions were taken from the records of the department. Classication was done according to WHO classication. Results: Of the 455 cases, 332 cases (73%) were benign, 16 cases (3.5%) cases were borderline and 107 cases (23.5%) cases were malignant. Among the histological subtypes surface epithelial tumors are common comprised of 76.9% followed by germ cell tumors (19.6%). Serous cystadenoma (42.8%) was the most common benign tumor followed by mature cystic teratoma (16.5%). Among the malignant tumors, the most common was Serous cyst adenocarcinoma (11.9%) Tumors were seen over age range of 11-81 years. Maximum number of cases were in the 4th to 6th decade. Benign tumors were primarily seen in Younger age group , whereas malignant tumors were common in elderly age group. Conclusions: In our study we analysed all the spectrum of ovarian tumors diagnosed on the basis of histomorphology. Surface epithelial tumors were the commonest ovarian tumor. Maximum numbers of ovarian tumors were in the age range 40-59years and malignant tumors were common in age >40 years

Problems in gynaecologic oncology in girls and young women—an outline of selected issues

Objective: The aim of the study was to present selected oncological problems among girls and young women. Mechanism: Malignant ovarian cancers grow faster in girls. Due to the lack of an anatomic barrier, they spread rapidly from the pelvis to the organs in the entire peritoneal cavity. High-grade cancers may be associated with an insufficient immune response that controls the early tumour growth. Findings and brief: Paediatric cancers represent about 1% of all diseases; fortunately, in developmental age gynaecology this is not a frequent problem, yet its significance requires intense specialist actions. Although they most often occur in adult women, malignant lesions may also affect girls (e.g., cervical germ cell tumour). Therefore, the importance of early detection of neoplastic ovarian lesions at any age is emphasised. Cervical cancer is also an oncological issue in developmental age gynaecology (the immature metaplastic epithelium is particularly sensitive to the oncogenic effects of HPV (Human Papillomavirus)), hence any prophylaxis, especially vaccinations, are of great importance in this respect). Apart from typical genital cancers, there can also be cancers where the genitourinary system is just one of the possible locations. Conclusions: Fortunately, cancers are not frequent in developmental age gynaecology, yet the significance of this problem requires intense specialist actions.

Histopathological Study of Non-neoplastic and Neoplastic Lesions of Ovary at a Tertiary Health Care Centre in Mangalore, Karnataka, India

Introduction: Ovarian tumours are one of the leading causes of gynaecologic malignancy and death in women. Carcinoma of ovary represents 30% of all cancers of the female genital tract. Morphologic diversities and non-specific symptoms of these tumours often pose a diagnostic challenge. Aim: To observe the histopathological spectrum of ovarian lesions in a tertiary care hospital and to find the distribution of benign and malignant neoplasms. Materials and Methods: This was a prospective study done at a tertiary care hospital in Mangalore, Karnataka, India on 100 ovarian lesions over the period of three years from September 2013 to September 2016. The specimens of ovaries, both neoplastic and non-neoplastic, were processed by routine histopathological techniques and stained by Haematoxylin and Eosin (H&E) stains. Chi-square test was used to find association between spectrum of lesions. Results: Of the 100 cases of ovarian lesions studied, majority were neoplastic lesions which constituted 51 cases (51%) and the remaining 49 (49%) were non-neoplastic. Among the non-neoplastic lesions, majority were corpus luteal cysts 25 (51%) followed by follicular cyst 17 (34.7 %). Out of the 51 neoplastic ovarian lesions, 32 (52.4%) were benign, 2 (3.2%) were borderline and 17 (27.8%) were malignant. Among the benign ovarian neoplasms, most commonly seen was serous cystadenoma followed by mucinous cystadenoma. In malignant cases, maximum were of serous cystadenocarcinoma (6 cases, 35.3%), followed by two cases each of mucinous cystadenocarcinoma and mixed germ cell tumour. There was one case of metastatic tumour to the ovary. Conclusion: Histopathological observations in this study provide valuable baseline information regarding the frequency and distribution of ovarian tumours. Histopathology remains the gold standard in the diagnosis of ovarian lesions and their proper recognition is important for appropriate therapy.

A retrospective study on histomorphological spectrum of ovarian lesions in a tertiary care hospital

Introduction: Gynecological morbidity is defined as any condition, disease, or dysfunction of thereproductive system which is not related to pregnancy, abortion, or childbirth. A significant numberof ovarian lesions have been known to cause Gynecological morbidity among most females. With theincreased use of screening modalities, ovarian lesions have increasingly been encountered forpathological analysis. It is important to evaluate the pattern of clinical presentation, corroboratingwith histological diagnosis. Purpose: The present study was carried out to evaluate thehistomorphological spectrum of various ovarian lesions among women in Puducherry. Material andMethods: This retrospective study was conducted on 350 ovarian samples received for five years inthe Department of Pathology, of our tertiary teaching hospital. Clinicopathological data wereretrieved from the hospital records. The histomorphological analysis was reviewed and neoplasticand non-neoplastic ovarian lesions were segregated according to the World Health Organizationclassification. Results: Based on histology, the predominant ovarian lesions diagnosed were non-neoplastic conditions including simple and follicular cyst, corpus luteal cyst, corpus hemorrhagiccyst, and cystic follicles constituting 40.6% on the right side and 34% on the left side. Malignancywas predominant on the right side (1.7%) while the same was 0.6% on the left side. Conclusion:The present study has identified that non-neoplastic lesions are more common in ovaries thanneoplastic lesions and it has identified that serous cystadenomas are the most common ovarianneoplastic lesions.

Histopathological and Clinicopathological Co-Relation of Non-Neoplastic Cystic Lesions in Surgically Removed Ovaries

Introduction: Neoplastic ovarian lesions have been extensively studied, but less attention is paid to non-neoplastic cystic lesions. Though follicular cysts are the most common of the non-neoplastic cysts, the % of occurrence of individual non-neoplastic lesions is not known. Also, often there is dilemma in reporting the exact type of nonneoplastic cyst. This study was planned with the objectives of assessing percentage of non neoplastic cystic ovaries, determining the morphological forms and relation of the various cysts with age of patient, and to detect whether multicystic non neoplastic lesions are more frequent in present day.
 Materials and methods: A prospective hospital based cross sectional non-neoplastic ovarian cysts study was done between January to June 2019 in a tertiary hospital. All hysterectomy specimens with the accompanying ovary/ovaries and oophorectomy specimen were included. Microscopic features were assessed. Data was tabulated in MS excel sheet. Percentage of occurrences of age, size, morphological type, laterality and complaints were calculated.
 Result:50% of 193 ovaries had non neoplastic cystic lesions. Non neoplastic cysts were associated with fibroid in 54%, DUB in 17% and adenomyosis in 16% cases. They were seen commonly during reproductive age group(83%). Post-menopausal age showed 16% cases. 86% of the non neoplastic ovarian cystic lesions were unilateral. 20% non neoplastic cystic lesions were of <1cm, 74% were 1-5 cm in size and 5% were larger than 5 cm. Morphologically 40% were follicular lesions, 32% were simple serous cysts, 14% were haemorrhagic cysts, 8% corpus luteal cysts and 2% each theca lutein and epithelial inclusion cysts.
 Conclusion: Non neoplastic cystic ovaries comprised 50% of all ovarian lesions, 83% were seen during reproductive age group. Leiomyoma, dysfunctional uterine bleeding and adenomyosis were the common clinical features and 70% of the cysts were 1-5 cm in size. There was no relation between morphological types of the cystic lesions and functional status. Simple serous cyst, cystic follicle, follicular cyst, cystic corpus luteum, corpus luteal cyst, theca luteal cyst, epithelial inclusion cyst and haemorrhagic cyst were found of which follicular cyst was the commonest (40%) Multicystic non neoplastic lesions or polycystic ovaries were not found during the period of study.

Histopathological patterns of ovarian lesions in various age groups-3 year study in a rural population

Introduction: Ovarian lesions are commonly encountered and are complex in gynecological practice which can be either benign, borderline or malignant which constitutes a high fatality rate and it cannot be categorized clinico - radiologically. Definite diagnosis is of great importance for therapeutic and prognostic purposes. Histopathology gives accurate diagnosis in most of the cases. Aims: To study the histopathological pattern of ovarian lesions in different age group and also to analyse the associated clinical and radiological findings. Methods: A retrospective study conducted on 69 cases of ovarian lesions reported from June 2016–May 2019 in pathology department at Sri Manakula Vinayagar medical college and hospital, Puducherry Results: Out of sixty nine ovarian lesions, 24 were non neoplastic and 45 were neoplastic lesions. Out of the neoplastic lesions 39 were benign and 6 were malignant. Among non-neoplastic lesions follicular cyst 12 was the most common lesion followed by endometriotic cysts 10. The majority of the cases were seen in the age group of 41-50 years. Conclusion: Most ovarian lesions were common in the age group 20-50 years. Neoplastic ovarian lesions are more common than non-neoplastic lesion.

Histomorphological Spectrum of Ovarian Lesions at a Rural Care Hospital in Gurugram

Background: The ovaries are paired intrapelvic organs of female reproductive system. It is unique in the variety of lesions that can arise from ovary as it is complex in its embryology, histology and steroidogenesis. The ovary consists of totipotent sex cord cells and multipotent mesenchymal cells. They are common site of non-neoplastic and neoplastic lesions. Some non-neoplastic lesions of the ovary usually present as a pelvic mass and mimic an ovarian neoplasm and thus posses a great challenge to gynecological oncologist and pathologist. Therefore their proper recognition and classification is important for appropriate therapy. Material and Methods: A prospective clinicopathological study of 58 cases of non-neoplastic and neoplastic lesions of ovary was conducted in Department of Pathology, FMHS, SGT University, Gurugram over the period of one years from June 2018 to June 2019. The materials for this study were oopherectomy specimen, ovarian cystectomies as well as hysterectomy with unilateral/bilateral salphingoopherectomy received from department of Obstetrics and Gynecology. The non-neoplastic and neoplastic lesions from representative sections were studied and classified according to World Health Organisation (WHO) and correlation of histopathological patterns with age, bilaterality, morphology and grading of the tumour was done. Results: A total of 58 cases were studied out of which 31 (53.45%) cases were non-neoplastic and 27 (46.55%) cases were neoplastic. Among the 31 nonneoplastic cases, the most common lesion found was simple cyst with 13 (41.94%) cases followed by corpus luteal cyst with 6 (19.35%) cases. Among the 27 neoplastic ovarian lesions, 17 (62.96%) cases were benign tumour, 2 (7.4%) cases were borderline tumour and 8 (29.64%) cases were malignant tumour. These tumours were classified according to WHO classification and categorised in three main groups. Surface epithelial tumours constituted the majority with 17 (62.98%) cases, followed by germ cell tumours which constituted 8 (29.62%) cases and sex cord stromal tumours constituted 2 (7.4%) cases. Conclusion: Ovarian cancers are called as “silent killer” as in most of the primary ovarian tumour they remain asymptomatic until the advanced stage. However, histomorphological study of tumour is still the gold standard method, these observations and results proved to be valuable base line information regarding frequency and pattern of ovarian tumours.

ROLE OF ULTRA SOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN OVARIAN MASS LESIONS

Introduction: Ovarian mass lesions are evaluated by ultrasound guided FNAC. It is useful to distinguish between neoplastic and non neoplastic ovarian masses.
 Aim: The aim of the study is to study the cyto-morphlogical features of ovarian masses.
 Materials and Methods: The present study is done over a period of two years i.e., from March 2017 to February 2019. A total number of 76 cases were studied in the Department of Pathology, Government Medical College, Kadapa. All the cases were categorised based on cyto-morphological features obtained ultra sound guided FNAC.
 Requirement of materials: 10 ml disposable syringe with 22-25 G needle, suitable fixative is Isopropyl alcohol, Alcohol fixed slides were taken for Heamatoxyllin and Eosin (H&E) stain.
 Results: In the present study we registered 76 cases. Among these 72 cases (94.73%) were primary tumors of ovary, two cases (2.63%) were secondaries and two cases (2.63%) were non neoplastic i.e., endometriosis of ovary.
 Key Words: Ultrasound guided FNAC, Non neoplastic, Neoplastic ovarian lesions, Kadapa

A CLINICO -PATHOLOGICAL STUDY OF NEOPLASTIC AND NON-NEOPLASTIC OVARIAN LESIONS.

Background: Ovarian lesions constitute a complex group with varied clinical behaviour and pathology. The ovaries constitute the internal reproductive organs their lesions can present in childhood to postmenopausal age group Clinical, radiological and gross examination alone cannot distinguish benign from malignant lesions; hence, histopathological examination is needed for their diagnosis and management.
 Objectives: A Clinico -pathological analysis of non-neoplastic and neoplastic ovarian lesions.
 Materials and methods: This descriptive study of one year comprised of 80 ovarian lesions diagnosed in the Department of Pathology, Bhagat Phool Singh Government medical college Sonipat. After thorough gross examination, representative bits were routinely processed and stained with H & E. Tumours were classified as per WHO classification.
 Results: Out of 80 ovarian lesions received, non-neoplastic lesions constituted 39% (31/80). Benign lesions constituted 45% (36/80) whereas borderline and malignant lesions constituted 5% (4/80) and 11.25% (9/80) respectively. Among non-neoplastic lesions, follicular cysts (67.7%) constituted the majority followed by corpus luteal cysts and endometriotic cysts. Among neoplastic lesions majority of the tumours were of surface epithelial type (69.38%) followed by germ cell tumours (18.36%). Bilateral lesions were seen in 17 (26.98%) patients while unilateral lesions were seen in 46 (73.01%) patients. Patients age varied from 16 to 75 years. For non-neoplastic lesions, patient age varied from 16 to 61 years. For neoplastic lesions patient age ranged from 18-75 years with age range of 18-75 years for benign tumours and 26-66 years for malignant tumours. Abnormal uterine bleeding was the commonest clinical presentation of non-neoplastic lesions. Benign and malignant tumours were most commonly associated with pain abdomen.
 Conclusion: Ovarian lesions comprise of variety of non-neoplastic and neoplastic lesions. By knowing clinical data, gross features, we can narrow our differential diagnosis and reach to the final diagnosis. So, early diagnosis and treatment definitely reduce the mortality from ovarian tumours.
 Keywords: Non-neoplastic, Benign, Malignant, Ovary, Lesions, Cysts, Tumours.

Study of histomorphological spectrum of ovarian neoplasms: an institutional perspective

Background: Ovarian tumours account for one of the top five gynaecological malignancies in Indian women. The prime objective of the current study is to document the frequency, age distribution and diverse histomorphological spectrum of ovarian tumours in a peripheral institute in South India catering rural population.Methods: The study comprises of retrospective clinico pathological evaluation of 77 cases of ovarian neoplasms in Indian Red Cross Cancer Hospital, Nellore, India during a 4 year period ( January 2015 to December 2018 ). Non neoplastic ovarian lesions were excluded. Gross and microscopic histopathological examination was done for ovarian neoplasms. These were classified according to the WHO classification of ovarian tumours (2003).Results: Out of 77 cases studied, majority were malignant tumours (72.72%), followed by benign (23.38%) and borderline tumours (3.9%). Age ranged from 11-80 years. Epithelial tumours were the most common (75.32%), followed by sex cord stromal tumours (12.98%), germ cell tumours (9.09%) and metastatic ovarian tumours (1.3%). Serous cystadenoma was the commonest benign tumour and serous papillary carcinoma was the commonest malignant ovarian tumour.Conclusions: It is concluded from this study that on morphological grounds, tumours originating from surface epithelium are the most common. Higher incidence of malignant tumours supports the metaphor often used for ovarian malignancy “ the silent killer ”.

Ultrasonography guided fine needle aspiration cytology of benign and malignant ovarian masses with histopathological correlation

Background: In recent past image guided fine needle aspiration cytology of ovarian masses is being used for the pre-operative diagnosis of neoplastic ovarian lesions, The imaging may be in the form of routinely performed ultrasonography and fine needle aspiration cytology is done from the solid component of lesion. Material and Methods: A prospective study was conducted at our tertiary care center over the period of two years. The 32 patients with ovarian masses encountered. The sensitivity, specificity and diagnostic accuracy of FNAC was calculated. Pitfalls and limitations of cytological evaluation and histopathological diagnosis has been highlighted.Results: The sensitivity of fine needle aspiration cytology in this study is 81.81%, Specificity is 95.23% and diagnostic accuracy is 90.60%.Conclusion: The Ultrasonography guided FNAC is less invasive, economic, rapid diagnostic mode of early evaluation of benign and malignant ovarian tumors and helps in early management.

Histopathological study of Non-neoplastic & Neoplastic ovarian lesions in a tertiary care hospital in Gujarat, India

Aims & Objectives:(1) To know about various histopathological types of ovarian lesions presented and diagnosed at our institute. (2) To study the incidence of ovarian lesions with respect to patient’s age. (3) To study the frequency of ovarian lesions in terms of non-neoplastic or neoplastic, benign or malignant, unilateral or bilateral, etc. Materials & Methods: The present study was performed at the Department of Pathology, GMERS Medical College & Hospital-Junagadh (Gujarat, India) from January 2015 to December 2018 and includes 100 cases of ovarian lesions diagnosed on both clinical & histopathological basis. We have received ovarian specimens and performed routine grossing and H& E staining procedure. We have included parameters like Age wise incidence, Nature of Lesion, Frequency & Laterality in this present study. Results: Out of100 cases, 89% are unilateral and 11% are bilateral. 52% lesions are Benign Neoplasms, 44% lesions are Non-neoplastic Cysts and 4% lesions are Borderline & Malignant Neoplasms. Majority of cases (58%) belong to age group of 20-39 years. Among Non-neoplastic Lesions, Follicular Cyst is common & frequently bilateral while among Benign Neoplasms, Serous Cystadenoma is common & frequently bilateral. Conclusion: Ovarian Lesions both non-neoplastic and neoplastic include a variety of morphological features and show a particular age wise incidence. Role of histopathological evaluation remains always important in both diagnosis & management of such cases, particularly in cases of Malignant Lesions in order to save the patient’s life.

Retrospective Study of histomorphological spectrum of ovarian tumours in GCS Medical College, Hospital and Research Center, Ahmedabad

Background and objectives: Ovarian tumours accounts for 30% of female genital cancers and have become increasingly important not only because of the large variety of neoplastic entities but also because they have gradually increased the mortality rate. Ovarian neoplasm remains asymptomatic until there is massive ovarian enlargement which causes compression of pelvic structures, ascites, abdominal distension or distant metastasis.Thus present study was undertaken to analyze the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumours. Methods: Retrospective study was carried during period of 1st June 2017 to 30st November 2018, 57 cases of ovarian neoplastic lesions were taken from the records of the department. Results: A total number of 57 cases were studied. Among these, 41cases (71.92%) were of benign tumours, 2 cases (3.50%) were of borderline tumours and 14 cases (24.56%) were of malignant tumours. Serous cystadenomas (26/41) (63.41%) were the commonest benign tumours followed by Mucinous cystadenomas (6/41)(14.63%). Among the malignant surface epithelial tumours serous cystadenocarcinomas (6/14) (42.86%) were most common followed by Mucinous cystadenocarcinomas (3/14) (21.43%). Germ cell neoplasms constituted 19.30% of all ovarian neoplasms. Conclusion: Ovarian tumours cannot easily be diagnosed by clinical symptoms only, histological examination is therefore necessary for diagnosis and grading of ovarian tumours. Females with family history of endometrial and breast carcinoma has got increased incidence of ovarian carcinoma and ovary is also common site for metastasis from other primary gynecological as well as non gynecological carcinomas e.g. endometrium, stomach and breast. Hence present study was carried out in the department of pathology for early diagnosis of ovarian carcinomas, their histological sub typing and their age distribution pattern.