Difference between revisions of "Ovary"

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**Cuboidal/flat epithelium.<ref>{{cite journal |author=Auersperg N, Wong AS, Choi KC, Kang SK, Leung PC |title=Ovarian surface epithelium: biology, endocrinology, and pathology |journal=Endocr. Rev. |volume=22 |issue=2 |pages=255–88 |year=2001 |month=April |pmid=11294827 |doi= |url=http://edrv.endojournals.org/cgi/pmidlookup?view=long&pmid=11294827}}</ref>
**Cuboidal/flat epithelium.<ref>{{cite journal |author=Auersperg N, Wong AS, Choi KC, Kang SK, Leung PC |title=Ovarian surface epithelium: biology, endocrinology, and pathology |journal=Endocr. Rev. |volume=22 |issue=2 |pages=255–88 |year=2001 |month=April |pmid=11294827 |doi= |url=http://edrv.endojournals.org/cgi/pmidlookup?view=long&pmid=11294827}}</ref>
**Has ovarian stroma underneath.
**Has ovarian stroma underneath.
**Nobnail morphology (free surface larger than basement membrane surface).<ref>ALS. 5 February 2009.</ref>  
**Hobnail morphology (free surface larger than basement membrane surface).<ref>ALS. 5 February 2009.</ref>  


Ovarian surface vs. mesothelium:
Ovarian surface vs. mesothelium:
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*[[AKA]] ''[[peritoneal inclusion cyst]]''.{{fact}}
*[[AKA]] ''[[peritoneal inclusion cyst]]''.{{fact}}
*[[AKA]] ''cortical inclusion cyst''.<ref name=pmid11207821>{{Cite journal  | last1 = Feeley | first1 = KM. | last2 = Wells | first2 = M. | title = Precursor lesions of ovarian epithelial malignancy. | journal = Histopathology | volume = 38 | issue = 2 | pages = 87-95 | month = Feb | year = 2001 | doi =  | PMID = 11207821 }}</ref>{{fact}}
*[[AKA]] ''cortical inclusion cyst''.<ref name=pmid11207821>{{Cite journal  | last1 = Feeley | first1 = KM. | last2 = Wells | first2 = M. | title = Precursor lesions of ovarian epithelial malignancy. | journal = Histopathology | volume = 38 | issue = 2 | pages = 87-95 | month = Feb | year = 2001 | doi =  | PMID = 11207821 }}</ref>{{fact}}
*[[AKA]] ''surface epithelial inclusion cyst''.
===General===
===General===
*May be found incidentally, e.g. during C-section.
*May be found incidentally, e.g. during C-section.
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DDx:
DDx:
*[[Serous cystadenoma of the ovary]].
*[[Serous cystadenoma of the ovary]] - must be >=1 cm.<ref name=Ref_GP384>{{Ref GP|384}}</ref>


Image:
Image:
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==Pregnancy luteoma==
==Pregnancy luteoma==
*[[AKA]] ''luteoma of [[pregnancy]]''.
*[[AKA]] ''luteoma of [[pregnancy]]''.
===General===
{{Main|Pregnancy luteoma}}
*Tumour of pregnancy.
*Benign.
*Regress after pregnancy; thus, conservative management.<ref name=pmid21144088>{{Cite journal  | last1 = Masarie | first1 = K. | last2 = Katz | first2 = V. | last3 = Balderston | first3 = K. | title = Pregnancy luteomas: clinical presentations and management strategies. | journal = Obstet Gynecol Surv | volume = 65 | issue = 9 | pages = 575-82 | month = Sep | year = 2010 | doi = 10.1097/OGX.0b013e3181f8c41d | PMID = 21144088 }}</ref>
 
Clinical:
*Increased serum testosterone.<ref name=pmid15782020>{{Cite journal  | last1 = Kao | first1 = HW. | last2 = Wu | first2 = CJ. | last3 = Chung | first3 = KT. | last4 = Wang | first4 = SR. | last5 = Chen | first5 = CY. | title = MR imaging of pregnancy luteoma: a case report and correlation with the clinical features. | journal = Korean J Radiol | volume = 6 | issue = 1 | pages = 44-6 | month =  | year =  | doi =  | PMID = 15782020 }}</ref>
*Increased CA125.<ref name=pmid10546765>{{Cite journal  | last1 = Rodriguez | first1 = M. | last2 = Harrison | first2 = TA. | last3 = Nowacki | first3 = MR. | last4 = Saltzman | first4 = AK. | title = Luteoma of pregnancy presenting with massive ascites and markedly elevated CA 125. | journal = Obstet Gynecol | volume = 94 | issue = 5 Pt 2 | pages = 854 | month = Nov | year = 1999 | doi =  | PMID = 10546765 }}
</ref><ref name=pmid25785161>{{Cite journal  | last1 = Wang | first1 = Y. | last2 = Zhou | first2 = F. | last3 = Qin | first3 = JL. | last4 = Qian | first4 = ZD. | last5 = Huang | first5 = LL. | title = Pregnancy luteoma followed with massive ascites and elevated CA125 after ovulation induction therapy: a case report and review of literatures. | journal = Int J Clin Exp Med | volume = 8 | issue = 1 | pages = 1491-3 | month =  | year = 2015 | doi =  | PMID = 25785161 }}</ref>
 
===Gross===
*Solid.
*Yellow.
 
Images:
*[http://www.flickr.com/photos/78147607@N00/4730745138 Pregnancy luteoma (flickr.com/euthman)].
*[http://www.flickr.com/photos/euthman/4730754894/in/photostream/ Pregnancy luteoma (flickr.com/euthman)].
 
===Microscopic===
Features:
*Sheets of cells.
*Cells with eosinophilic cytoplasm, round nuclei and prominent [[nucleoli]].
 
DDx:
*[[Leydig cell tumour]].
 
====Images====
*[http://www.webpathology.com/image.asp?case=522&n=1 Pregnancy luteoma - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=522 Pregnancy luteoma - high mag. (webpathology.com)].
 
===IHC===
*Inhibin +ve.<ref name=pmid25785161/>


=Ovarian tumours=
=Ovarian tumours=

Latest revision as of 10:08, 5 August 2017

The ovary has a wealth of pathology. It has benign tumours and malignant ones. It is a significant part of gynecologic pathology.

Normal ovary

  • Corpora albicans - pale/white body with lobulated contour.
    • Involuted corpus luteum.
    • Not seen pre-pubertal.
    • Number increase with age.
  • Ovarian follicles.
  • Stroma - hyperchromatic - spindle morphology, whorling.
    • If the cells have a round morphology... think about endometriosis.

Images

www:

  • Corpus albicans. (WC)

Cysts - overview

General

  • Very common.

Most common:

  • Serous cystadenoma.
    • Usually uniloculated.
    • Morphology: ciliated, columnar.
  • Mucinous cystadenoma.
    • Usually multiloculated.[1]
      • Memory device: multiloculated = mucinous.
  • Endometrioma (see endometriosis).
  • Simple cyst.
  • Corpus luteum cyst.
  • Cancerous cyst (see ovarian cancer).

Notes:

  • Epithelium is often lost in processing - may make interpretation challenging
  • Ovarian surface epithelium (previously call germinal epithelium) - covers the ovary
    • Cuboidal/flat epithelium.[2]
    • Has ovarian stroma underneath.
    • Hobnail morphology (free surface larger than basement membrane surface).[3]

Ovarian surface vs. mesothelium:

Specific benign diagnoses

Endometriosis

Main article: Endometriosis

Corpus luteum cyst

General

  • Normal in childbearing age women.

Gross

  • Classically yellow.

Microscopic

Features:

  • Pseudocyst lined by stratified, pale staining (luteinized) cells.
  • +/-Hemorrhagic centre.

Images:

Benign mesothelial inclusion cyst

General

  • May be found incidentally, e.g. during C-section.

Epidemiology:

  • Associated with previous surgery.

Gross

  • May mimic mucinous tumour - to unexperienced.[5]
  • Thin-wall.[6]
  • Clear/translucent fluid.

Microscopic

Features:

  • Benign mesothelium.
    • Single layer of squamoid or cuboid mesothelial cells.[6]

DDx:

Image:

IHC

Sign out

OVARY, LEFT, BIOPSY:
- BENIGN CORTICAL INCLUSION CYST.

Ovarian infarct

Main article: Ovarian infarct

Pregnancy luteoma

Main article: Pregnancy luteoma

Ovarian tumours

Main article: Ovarian tumours

For a very brief overview of gynecologic tumours see: Gynecologic pathology.

See also

References

  1. ↑ IAV. 6 February 2009.
  2. ↑ Auersperg N, Wong AS, Choi KC, Kang SK, Leung PC (April 2001). "Ovarian surface epithelium: biology, endocrinology, and pathology". Endocr. Rev. 22 (2): 255–88. PMID 11294827. http://edrv.endojournals.org/cgi/pmidlookup?view=long&pmid=11294827.
  3. ↑ ALS. 5 February 2009.
  4. ↑ Feeley, KM.; Wells, M. (Feb 2001). "Precursor lesions of ovarian epithelial malignancy.". Histopathology 38 (2): 87-95. PMID 11207821.
  5. ↑ GAG 26 Feb 2009.
  6. ↑ 6.0 6.1 6.2 Urbanczyk K, Skotniczny K, Kucinski J, Friediger J (2005). "Mesothelial inclusion cysts (so-called benign cystic mesothelioma)--a clinicopathological analysis of six cases". Pol J Pathol 56 (2): 81-7. PMID 16092670.
  7. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 384. ISBN 978-0443069208.
  8. ↑ Asch, E.; Levine, D.; Kim, Y.; Hecht, JL. (Mar 2008). "Histologic, surgical, and imaging correlations of adnexal masses.". J Ultrasound Med 27 (3): 327-42. PMID 18314510.
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