Question 238

Question:

A 55-year-old woman has a hysterectomy and bilateral salpingo-oophorectomy for abnormal uterine bleeding. Histologic examination of the ovaries shows small atretic follicles. Which of the following processes is the most likely cause of these histologic findings?

Correct Answer: A.  Apoptosis

Small, atretic ovarian follicles are a normal finding in post-menopausal women. As women enter menopause, their ovaries lose the ability to support viable ova and follicles. This process of planned cell death is called apoptosis. By contrast, necrosis is unplanned cell death caused by an insult to previously viable tissue. Metaplasia and transformation are associated with neoplastic processes, which may be occurring in this woman’s uterus leading to bleeding. Don’t be fooled, the question asks not about uterine histological findings, but rather about those in the ovaries which are entirely benign.