Ovary

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:

• Ovarian stroma (photobucket.com).

• 

  Corpus albicans. (WC)

Cysts - overview

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.
• 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.
  • Has ovarian stroma underneath.
  • Hobnail morphology (free surface larger than basement membrane surface).

Ovarian surface vs. mesothelium:

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

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:

• Luteinized cells in a follicular cyst (WC).
• Corpus luteum (unsw.edu.au).

Benign mesothelial inclusion cyst

• AKA mesothelial inclusion cyst.
• AKA peritoneal inclusion cyst.^{[citation needed]}
• AKA cortical inclusion cyst.^{[citation needed]}
• AKA surface epithelial inclusion cyst.

General

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

Epidemiology:

• Associated with previous surgery.

Gross

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

Microscopic

Features:

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

DDx:

• Serous cystadenoma of the ovary - must be >=1 cm.

Image:

• Cortical inclusion cyst (jultrasounmed.org).

IHC

• CK +ve, calretinin +ve.

Sign out

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

Ovarian infarct

Main article: Ovarian infarct

Pregnancy luteoma

• AKA luteoma of pregnancy.

Main article: Pregnancy luteoma

Ovarian tumours

Main article: Ovarian tumours

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

See also

• Gynecologic pathology.
• Testis.