Ovarian cyst: Difference between revisions

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==Presentations==
Typically a '''[[cyst]]''' with more or less of the '''[[ovary]]'''.
{{Comprehensiveness|otherlegend=yes}}
==Gross processing==
[[File:Ovarian cyst transillumination.jpg|thumb|250px|Transillumination may help in identifying thickened areas of the cyst. This example also shows papillary excrescences near the bottom.]]
The specimen is generally not [[inking|inked]].
===Gross report===
Example:
{|class=wikitable
| {{Moderate-begin}}Labeled - ___.{{Moderate-end}} The specimen is received in formalin and consists of an ovary with a cyst, and attached portion of the fallopian tube, in total measuring ___.  The capsule of the ovary and the cyst is tan-pink and smooth. The cyst is << intact / collapsed>>{{Finding-begin}}, with a wall defect measuring _ cm{{Finding-end}}. Upon {{Finding-begin}}further{{Finding-end}} opening the contents of the cyst consists of ___. The cyst lining is tan-pink and smooth, with a wall thickness of __. There are no papillary excrescences. Cut sections of the ovary reveal solid, white and whorled parenchyma, and no gross lesions. The attached fallopian tube fragment measures ___, and displays fimbria. Cut sections of the tube reveal a patent lumen. Representative sections are submitted for microscopic examination in __ cassettes.
|}


==Microscopic evaluation==
==Microscopic evaluation==
Attempt to classify into either of the following:
If there are solid components, evaluate those as '''[[ovarian tumor]]s'''.
 
Attempt to classify cysts into either of the following:
{|class="wikitable"
{|class="wikitable"
! Type !! Subtype !! Typical microscopy findings !! Image
! Type !! Subtype !! Typical microscopy findings !! Image
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*A variable inner layer of [[granulosa cell]]s which are luteinized after puberty<ref name=Ghofrani>{{cite web|url=https://www.pathologyoutlines.com/topic/ovarynontumorfollicularcysts.html|title=Ovary - nontumor - Nonneoplastic cysts / other - Follicular cysts|author=Mohiedean Ghofrani|website=Pathology Outlines}} Topic Completed: 1 August 2011. Revised: 5 March 2020</ref>
*A variable inner layer of [[granulosa cell]]s which are luteinized after puberty<ref name=Ghofrani>{{cite web|url=https://www.pathologyoutlines.com/topic/ovarynontumorfollicularcysts.html|title=Ovary - nontumor - Nonneoplastic cysts / other - Follicular cysts|author=Mohiedean Ghofrani|website=Pathology Outlines}} Topic Completed: 1 August 2011. Revised: 5 March 2020</ref>
*An outer layer of usually luteinized [[theca interna]]<ref name=Ghofrani/>
*An outer layer of usually luteinized [[theca interna]]<ref name=Ghofrani/>
| [[File:Graafian Follicle, Human Ovary (3595817584).jpg|150px]]
| [[File:Graafian Follicle, Human Ovary (3595817584).jpg|110px]]
|-
|-
! [[Corpus luteum cyst]]
! [[Corpus luteum cyst]]
|  
|  
*A convoluted cyst lining of luteinized granulosa cells<ref name=Busca>{{cite web|url=http://www.pathologyoutlines.com/topic/ovarynontumorcorpuslutcyst.html|title=Ovary - nontumor - Nonneoplastic cysts / other - Corpus luteum cyst (CLC)|author=Aurelia Busca, Carlos Parra-Herran|website=Pathology Outlines}} Topic Completed: 1 November 2016. Revised: 5 March 2020</ref>
*A convoluted cyst lining of luteinized granulosa cells<ref name=Busca>{{cite web|url=http://www.pathologyoutlines.com/topic/ovarynontumorcorpuslutcyst.html|title=Ovary - nontumor - Nonneoplastic cysts / other - Corpus luteum cyst (CLC)|author=Aurelia Busca, Carlos Parra-Herran|website=Pathology Outlines}} Topic Completed: 1 November 2016. Revised: 5 March 2020</ref>
*A prominent inner layer of fibrous tissue<ref name=Busca/>
*A prominent fibrous<ref name=Busca/> to hemorrhagic inner layer
*An outer layer of theca cells<ref name=Busca/>
*An outer layer of theca cells<ref name=Busca/>
| [[File:Histopathology of hemorrhagic corpus luteum cyst.jpg|150px]]
| [[File:Histopathology of a corpus luteum cyst, low magnification.jpg|200px]]
|-
|-
!rowspan=2| Cystadenoma !! [[Ovarian serous cystadenoma|Serous cystadenoma]]
!rowspan=2| Cystadenoma !! [[Ovarian serous cystadenoma|Serous cystadenoma]]
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! colspan=2| [[Borderline tumor]]
! colspan=2| [[Borderline tumor]]
| Atypical epithelial proliferation without stromal invasion.<ref>{{cite web|url=https://www.uptodate.com/contents/borderline-ovarian-tumors|title=Borderline ovarian tumors|website=[[UpToDate]]|author=Lee-may Chen, MDJonathan S Berek, MD, MMS}} This topic last updated: Feb 08, 2019.</ref>
| Atypical epithelial proliferation without stromal invasion.<ref>{{cite web|url=https://www.uptodate.com/contents/borderline-ovarian-tumors|title=Borderline ovarian tumors|website=[[UpToDate]]|author=Lee-may Chen, MDJonathan S Berek, MD, MMS}} This topic last updated: Feb 08, 2019.</ref>
| [[File:Histopathology of seromucinous borderline tumors.jpg|120px]]
| [[File:Histopathology of ovarian serous borderline tumor.jpg|200px]]
|-
|-
!colspan=2| [[Ovarian cancer]]
!colspan=2| [[Ovarian cancer]]
| Many different types, but generally severe dysplasia/atypia and invasion.
| Many different types, but generally severe dysplasia/atypia and invasion.
| [[File:Serous carcinoma (3061775966).jpg|thumb|120px|[[Serous carcinoma]].]]
| [[File:Serous carcinoma (3061775966).jpg|thumb|180px|[[Serous carcinoma]].]]
|-
|-
!colspan=2| Simple squamous cyst
!colspan=2| Simple cyst /<br>simple squamous cyst
| Simple squamous epithelium and not conforming to diagnoses above || [[File:Histopathology of simple squamous cyst wall.jpg|150px]]
| Simple squamous epithelium and not conforming to diagnoses above || [[File:Histopathology of simple squamous cyst wall.jpg|170px]]
|}
|}
{{Bottom}}
{{Bottom}}

Latest revision as of 18:21, 13 April 2024

Author: Mikael Häggström [note 1]

Presentations

Typically a cyst with more or less of the ovary.

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))
Other legend

<< Decision needed between alternatives separated by / signs >>
{{Common findings / In case of findings}}
[[Comments]]
Link to another page

Gross processing

Transillumination may help in identifying thickened areas of the cyst. This example also shows papillary excrescences near the bottom.

The specimen is generally not inked.

Gross report

Example:

(Labeled - ___.) The specimen is received in formalin and consists of an ovary with a cyst, and attached portion of the fallopian tube, in total measuring ___. The capsule of the ovary and the cyst is tan-pink and smooth. The cyst is << intact / collapsed>>{{, with a wall defect measuring _ cm}}. Upon {{further}} opening the contents of the cyst consists of ___. The cyst lining is tan-pink and smooth, with a wall thickness of __. There are no papillary excrescences. Cut sections of the ovary reveal solid, white and whorled parenchyma, and no gross lesions. The attached fallopian tube fragment measures ___, and displays fimbria. Cut sections of the tube reveal a patent lumen. Representative sections are submitted for microscopic examination in __ cassettes.

Microscopic evaluation

If there are solid components, evaluate those as ovarian tumors.

Attempt to classify cysts into either of the following:

Type Subtype Typical microscopy findings Image
Functional cyst Follicular cyst
Corpus luteum cyst
  • A convoluted cyst lining of luteinized granulosa cells[2]
  • A prominent fibrous[2] to hemorrhagic inner layer
  • An outer layer of theca cells[2]
Cystadenoma Serous cystadenoma Cyst lining consisting of a simple epithelium, whose cells may be either:[3]
  • columnar and tall and contain cilia, resembling normal tubal epithelium
  • cuboidal and have no cilia, resembling ovarian surface epithelium
Mucinous cystadenoma Lined by a mucinous epithelium
Mature cystic teratoma
(dermoid) 		Well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).[4]
Endometriosis At least two of the following three criteria:[5]
Borderline tumor Atypical epithelial proliferation without stromal invasion.[6]
Ovarian cancer Many different types, but generally severe dysplasia/atypia and invasion.
Serous carcinoma.
Simple cyst /
simple squamous cyst 		Simple squamous epithelium and not conforming to diagnoses above

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ 1.0 1.1 Mohiedean Ghofrani. Ovary - nontumor - Nonneoplastic cysts / other - Follicular cysts. Pathology Outlines. Topic Completed: 1 August 2011. Revised: 5 March 2020
  2. ↑ 2.0 2.1 2.2 Aurelia Busca, Carlos Parra-Herran. Ovary - nontumor - Nonneoplastic cysts / other - Corpus luteum cyst (CLC). Pathology Outlines. Topic Completed: 1 November 2016. Revised: 5 March 2020
  3. ↑ Shahrzad Ehdaivand, M.D.. Ovary tumor - serous tumors - Serous cystadenoma / adenofibroma / surface papilloma. Pathology Outlines. Topic Completed: 1 June 2012. Revised: 5 March 2020
  4. ↑ Sahin, Hilal; Abdullazade, Samir; Sanci, Muzaffer (2017). "Mature cystic teratoma of the ovary: a cutting edge overview on imaging features ". Insights into Imaging 8 (2): 227–241. doi:10.1007/s13244-016-0539-9. ISSN 1869-4101. 
  5. ↑ Aurelia Busca, Carlos Parra-Herran. Ovary - nontumor - Nonneoplastic cysts / other - Endometriosis. Pathology Outlines. Topic Completed: 1 August 2017. Revised: 5 March 2020
  6. ↑ Lee-may Chen, MDJonathan S Berek, MD, MMS. Borderline ovarian tumors. UpToDate. This topic last updated: Feb 08, 2019.

Image sources


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