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Turk Patoloji Dergisi 2021Immunoglobulin G4-related disease is characterized by dense fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltration that contains abundant IgG4 positive...
Immunoglobulin G4-related disease is characterized by dense fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltration that contains abundant IgG4 positive plasma cells. It causes tumefactive lesions in the involved organs and is most commonly seen in the salivary glands, pancreas, and retroperitoneum. Ovarian involvement has been reported in only two cases. In our case, a 58-year-old female patient presented with abdominal distention and pain. Pelvic computed tomography revealed a soft tissue lesion compatible with the omental cake, several intraabdominal implants, and bilateral adnexal fullness. A laparotomy was performed under suspicion of peritoneal carcinomatosis secondary to bilateral adnexal mass. In the histopathologic examination, abundant lymphoplasmacytic infiltration and dense fibrosis were observed in both ovaries and the peritoneum. In the areas of greatest density, the density of IgG4-positive plasma cells was found to range from 40 to 50 per high-power field. The patient was accepted as suffering from probable IgG4-related disease because of the bilateral involvement of the ovaries and the histopathological findings. In conclusion, we present this case to draw attention to the fact that IgG4-related disease can also be seen in the ovary.
Topics: Diagnosis, Differential; Female; Fibrosis; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Middle Aged; Ovarian Diseases; Ovarian Neoplasms; Ovary; Plasma Cells
PubMed: 32779156
DOI: 10.5146/tjpath.2020.01500 -
American Family Physician Apr 2016Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or... (Review)
Review
Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times per month in less than a year should be evaluated for ovarian cancer. Pelvic examination has low sensitivity for detecting an adnexal mass; negative pelvic examination findings in a symptomatic woman should not deter further workup. Ectopic pregnancy must be ruled out in women of reproductive age. A cancer antigen 125 (CA 125) test may assist in the evaluation of an adnexal mass in appropriate patients. CA 125 levels are elevated in conditions other than ovarian cancer. Because substantial overlap in CA 125 levels between pre- and postmenopausal women may occur, this level alone is not recommended for differentiating between a benign and a malignant adnexal mass. Transvaginal ultrasonography is the first choice for imaging of an adnexal mass. Large mass size, complexity, projections, septation, irregularity, or bilaterality may indicate cancer. If disease is suspected outside of the ovary, computed tomography may be indicated; magnetic resonance imaging may better show malignant characteristics in the ovary. Serial ultrasonography and periodic measurement of CA 125 levels may help in differentiating between benign or potentially malignant adnexal masses. If an adnexal mass larger than 6 cm is found on ultrasonography, or if findings persist longer than 12 weeks, referral to a gynecologist or gynecologic oncologist is indicated.
Topics: Adnexal Diseases; CA-125 Antigen; Chorionic Gonadotropin, beta Subunit, Human; Diagnosis, Differential; Endometriosis; Female; Gynecological Examination; Humans; Leiomyoma; Magnetic Resonance Imaging; Ovarian Cysts; Ovarian Diseases; Ovarian Neoplasms; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Pregnancy; Pregnancy, Ectopic; Tomography, X-Ray Computed; Torsion Abnormality; Ultrasonography; Uterine Neoplasms
PubMed: 27175840
DOI: No ID Found -
Human Reproduction Update 2014The remodelling of the blood vasculature has been the subject of much research while rapid progress in the understanding of the factors controlling lymphangiogenesis in... (Review)
Review
BACKGROUND
The remodelling of the blood vasculature has been the subject of much research while rapid progress in the understanding of the factors controlling lymphangiogenesis in the ovary has only been reported more recently. The ovary undergoes cyclic remodelling throughout each menstrual/estrous cycle. This process requires significant vascular remodelling to supply each new cohort of growing follicles.
METHODS
Literature searches were performed to review studies on the ovarian lymphatic vasculature that described spatial, temporal and functional data in human or animal species. The role of ovarian blood and lymphatic vasculature in the pathogenesis of ovarian disease and dysfunction was also explored.
RESULTS
Research in a number of species including zebrafish, rodents and primates has described the lymphatic vasculature within the remodelling ovary, while recent research in mouse has confirmed hormonal regulation of lymphangiogenic growth factors, their receptors and also a role for the protease, ADAMTS1 in the development of the lymphatic vasculature. With a critical role in the maintenence of fluid homeostasis, the ovarian lymphatic vasculature is important for normal ovarian function and has been linked to syndromes involving ovarian fluid imbalance, including ovarian hyperstimulation syndrome and massive ovarian edema. The lymphatic vasculature has also been heavily implicated in the metastatic cancer process.
CONCLUSION
The spatial and temporal regulation of the ovarian lymphatic vasculature has now been reported in a number of species and the data also implicate the ovarian lymphatic vasculature in ovarian pathologies, including cancer and those linked with use of artificial reproduction technologies.
Topics: Animals; Female; Humans; Lymphangiogenesis; Lymphatic Vessels; Neovascularization, Physiologic; Ovarian Diseases; Ovarian Follicle; Ovary
PubMed: 24097804
DOI: 10.1093/humupd/dmt049 -
The American Journal of Emergency... Jun 2022Ovarian torsion is a rare, frequently misdiagnosed condition that carries with it a high rate of morbidity. (Review)
Review
INTRODUCTION
Ovarian torsion is a rare, frequently misdiagnosed condition that carries with it a high rate of morbidity.
OBJECTIVE
This review highlights the pearls and pitfalls of ovarian torsion, including presentation, evaluation, and management in the emergency department (ED) based on current evidence.
DISCUSSION
Ovarian torsion is one of the most common gynecological surgical emergencies and occurs with complete or partial rotation of the ovary along the supporting ligaments, obstructing vascular flow. Several risk factors include the presence of an ovarian mass or cyst. The most common population affected includes reproductive aged women, though cases also occur in premenarchal females, pregnant women, and postmenopausal women. Abdominal or pelvic pain is common but is not always sudden in onset or severe. Nausea and vomiting occur in 70%. Ultrasound can assist with diagnosis, but a normal ultrasound examination cannot exclude the diagnosis. Computed tomography with intravenous contrast can assist with diagnosis. Treatment includes emergent gynecologic consultation for surgical detorsion, along with symptomatic therapy in the ED.
CONCLUSIONS
An understanding of ovarian torsion can assist emergency clinicians in diagnosing and managing this disease.
Topics: Adnexal Diseases; Adult; Female; Gynecologic Surgical Procedures; Humans; Ovarian Diseases; Ovarian Torsion; Pregnancy; Prevalence; Torsion Abnormality
PubMed: 35397355
DOI: 10.1016/j.ajem.2022.03.046 -
International Journal of Gynecological... Mar 2017IgG4-related disease has been previously described to involve numerous organs and anatomic sites, however, involvement of the ovary has not yet been reported in the...
IgG4-related disease has been previously described to involve numerous organs and anatomic sites, however, involvement of the ovary has not yet been reported in the literature. In this case report we describe an ovary involved with an inflammatory process with histopathologic features supportive of involvement by IgG4-related disease: a dense lymphoplasmacytic infiltrate with an eosinophilic component, obliterative phlebitis, and a prominent proportion of IgG-positive cells with IgG4 expression by immunohistochemistry (40%-50%). The differential diagnosis for this case would include eosinophilic perifolliculitis involving the ovary, another rare entity that shares the eosinophilic component of IgG4-related disease. In short, we present the first description of IgG4-related disease of the ovary providing morphologic characterization and immunohistochemical studies supporting the diagnosis.
Topics: Autoimmune Diseases; Biomarkers; Female; Humans; Immunoglobulin G; Immunohistochemistry; Middle Aged; Ovarian Diseases
PubMed: 27149005
DOI: 10.1097/PGP.0000000000000293 -
Cellular & Molecular Immunology Nov 2014The ovary is not an immunologically privileged organ, but a breakdown in tolerogenic mechanisms for ovary-specific antigens has disastrous consequences on fertility in... (Review)
Review
The ovary is not an immunologically privileged organ, but a breakdown in tolerogenic mechanisms for ovary-specific antigens has disastrous consequences on fertility in women, and this is replicated in murine models of autoimmune disease. Isolated ovarian autoimmune disease is rare in women, likely due to the severity of the disease and the inability to transmit genetic information conferring the ovarian disease across generations. Nonetheless, autoimmune oophoritis is often observed in association with other autoimmune diseases, particularly autoimmune adrenal disease, and takes a toll on both society and individual health. Studies in mice have revealed at least two mechanisms that protect the ovary from autoimmune attack. These mechanisms include control of autoreactive T cells by thymus-derived regulatory T cells, as well as a role for the autoimmune regulator (AIRE), a transcriptional regulator that induces expression of tissue-restricted antigens in medullary thymic epithelial cells during development of T cells. Although the latter mechanism is incompletely defined, it is well established that failure of either results in autoimmune-mediated targeting and depletion of ovarian follicles. In this review, we will address the clinical features and consequences of autoimmune-mediated ovarian infertility in women, as well as the possible mechanisms of disease as revealed by animal models.
Topics: Adrenal Gland Diseases; Animals; Autoimmune Diseases; Disease Models, Animal; Female; Humans; Infertility, Female; Mice; Ovarian Diseases; T-Lymphocytes, Regulatory; Transcription Factors; AIRE Protein
PubMed: 25327908
DOI: 10.1038/cmi.2014.97 -
Cold Spring Harbor Perspectives in... May 2015MicroRNAs (miRNAs) are posttranscriptional gene regulatory molecules that show regulated expression within ovarian tissue. Most research investigating miRNAs in the... (Review)
Review
MicroRNAs (miRNAs) are posttranscriptional gene regulatory molecules that show regulated expression within ovarian tissue. Most research investigating miRNAs in the ovary has relied exclusively on in vitro analyses. In this review, we highlight those few studies in which investigators have illustrated an in vivo effect of miRNAs on ovarian function. We also provide a synopsis of how these small noncoding RNAs can impact ovarian disease. miRNAs have great potential as novel diagnostic biomarkers for the detection of ovarian disease and in the assisted reproductive technologies (ART) for selection of healthy viable oocytes and embryos.
Topics: Animals; Biomarkers; Corpus Luteum; Disease Models, Animal; Female; Fertility; Humans; Mice; MicroRNAs; Oocytes; Ovarian Diseases; Ovarian Follicle; Ovary; Reproductive Techniques, Assisted; Terminology as Topic
PubMed: 25986593
DOI: 10.1101/cshperspect.a022962 -
The Surgical Clinics of North America Feb 2017Adnexal torsion is the fifth most common gynecologic emergency. The vague clinical presentation and variable imaging findings make the diagnosis difficult. If suspicion... (Review)
Review
Adnexal torsion is the fifth most common gynecologic emergency. The vague clinical presentation and variable imaging findings make the diagnosis difficult. If suspicion for adnexal torsion is high enough based on clinical symptoms and imaging findings, prompt intervention should include conservative management with laparoscopic adnexal detorsion and ovarian preservation even in the event of a necrotic-appearing ovary because studies persistently show follicular development and ovarian function after a short time period and no increased patient morbidity.
Topics: Child; Disease Management; Female; Gynecologic Surgical Procedures; Humans; Ovarian Diseases; Torsion Abnormality
PubMed: 27894428
DOI: 10.1016/j.suc.2016.08.008 -
Obstetrics and Gynecology Clinics of... Dec 2019Ovarian lesions are common and require a consistent approach to diagnosis and management for best patient outcomes. In the past 20 years, there has been an evolution in... (Review)
Review
Ovarian lesions are common and require a consistent approach to diagnosis and management for best patient outcomes. In the past 20 years, there has been an evolution in the approach to abnormal ovarian lesions, with increasing emphasis on reducing surgery for benign disease, standardizing terminology, assessing risk of malignancy through use of evidence-based scoring systems, and triaging suspicious abnormalities to dedicated oncology centers. This article provides an evidence-based review of how these changes in diagnosis and management of ultrasound-detected abnormal ovarian lesions have occurred. Current recommended practices are summarized. The current literature on transvaginal screening for ovarian cancer also is reviewed and summarized.
Topics: Carcinogenesis; Disease Progression; Female; Humans; Ovarian Cysts; Ovarian Diseases; Ovarian Neoplasms; Ovary; Ultrasonography
PubMed: 31677745
DOI: 10.1016/j.ogc.2019.07.002 -
Annales D'endocrinologie Nov 2019Sphingosine-1-phoshate (S1P) is a membrane sphingolipid involved in several physiological processes, including cell proliferation, tissue growth, cell survival and... (Review)
Review
Sphingosine-1-phoshate (S1P) is a membrane sphingolipid involved in several physiological processes, including cell proliferation, tissue growth, cell survival and migration, inflammation, vasculogenesis, and angiogenesis. Herein, we review the most critical effects of S1P on ovarian function, including its physiological and pathophysiological effects. Based on the available evidence, S1P plays an important role in ovarian physiology, participating as an essential stimulator of follicular development in both the preantral and antral phases, as well as in ovulation and corpus luteum development. Moreover, S1P may be a good cytoprotective agent against cancer treatment side-effects (chemotherapy with or without radiation therapy). In the future, this compound may be given for fertility preservation to women undergoing cancer treatment. However, further studies are required to confirm its efficacy in ovarian protection and also its safety in terms of cancer prognosis, given the biological action of the compound. Under- or over-production of S1P may be related to ovarian pathologies.
Topics: Animals; Cell Proliferation; Corpus Luteum; Female; Fertility Preservation; Humans; Lysophospholipids; Ovarian Diseases; Ovarian Follicle; Ovarian Neoplasms; Ovary; Sphingosine; Sphingosine-1-Phosphate Receptors
PubMed: 31455516
DOI: 10.1016/j.ando.2019.06.003