Ovary

The ovary has a wealth of pathology. It has benign tumours and malignant ones.

Normal

• Corpora albicans - pale/white body with lobulated contour.
• Ovarian follicles.
• Stroma - hyperchromatic - spindle morphology, whorling.
  • If the cells have a round morphology... think about endometriosis.

Micrograph

• Ovarian stroma (photobucket.com).

Cysts

General:

• Very common.

Most common:

• Serous cystadenoma.
  • Usually uniloculated.
  • Morphology: ciliated, columnar.
• Mucinous cystadenoma.
  • Usually multiloculated.
    • Memory device: multiloculated = mucinous.
• Endometrioma (see endometriosis).
• Simple 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.
  • Has ovarian stroma underneath.
  • Nobnail morphology (free surface larger than basement membrane surface).

Ovarian surface vs. mesothelium:

• Image: ovarian surface epithelium - endojournals.org.
• Image: mesothelium - internetattitude.com.

Endometriosis

Main article: Endometriosis

Ovarian tumours

Main article: Ovarian tumours

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

Benign mesothelial inclusion cyst

Epidemiology

• Assoc. with previous surgery.
• May be found incidentally, e.g. during C-section.

Gross

• May mimic mucinous tumour - to unexperienced.
• Thin-wall.
• Clear/translucent fluid.

Microscopic

Features:

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

IHC

• CK +ve, calretinin +ve.

Pregnancy luteoma

General

• Tumour of pregnancy.
• Benign.
• Regress after pregnancy; thus, conservative management.

Microscopic

Features:

• Sheets of cells.
• Cells with eosinophilic cytoplasm, round nuclei and prominent nucleoli.

DDx:

• Leydig cell tumour.

See also

• Gynecologic pathology.
• Testis.