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Ovary - nontumor

Non-neoplastic cysts/other

Large solitary luteinized follicular cyst of pregnancy and puerperium


Reviewer: Shahid Islam, M.D., (see Reviewers page)
Revised: 3 June 2014, last major update June 2012
Copyright: (c) 2002-2014, PathologyOutlines.com, Inc.

General
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● Rare solitary follicular cyst that occurs during pregnancy and puerperium, may be related to hCG
● Palpable adnexal mass or seen at C-section
● No clinical endocrine disturbance

Treatment
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● Conservative, most regress during puerperium, may need to excise if symptomatic (Obstet Gynecol 2005;105:1218)

Gross description
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● Large, solitary, unilocular cyst, resembles follicular cyst, but markedly larger (median size - 25 cm)

Gross images
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25 cm unilocular cyst

Micro description
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● Cyst lined by 1 or more layers of luteinized cells with clear to pink cytoplasm, no theca/granulosa distinction
● Focal nuclear atypia (enlarged, pleomorphic and hyperchromatic nuclei) is probably degenerative
● Also nests of luteinized cells within fibrous tissue of cyst wall (Pathol Res Pract 2006;202:471)
● May have a few mitotic figures (Diagn Pathol 2011 Jan 10;6:3)

Micro images
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Various images

Contributed by: Dr. Raul Gonzalez, Vanderbilt University (USA):


               
Various images

Differential diagnosis
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● Cystic ovarian neoplasm (low N/C ratio, sporadic atypia and clinical setting favor a solitary follicular cyst)

Additional references
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Am J Surg Pathol 1980;4:431, Arch Pathol Lab Med 1986;110:928

End of Ovary - nontumor > Non-neoplastic cysts/other > Large solitary luteinized follicular cyst of pregnancy and puerperium


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