Ovary nontumor
Non-neoplastic cysts / other
Corpus luteum cyst (CLC)

Author: Aurelia Busca, M.D., Ph.D. (see Authors page)

Editor: Carlos Parra-Herran, M.D.

Revised: 3 December 2016, last major update November 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Corpus luteum cyst[title]
Cite this page: Corpus luteum cyst. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarynontumorcorpuslutcyst.html. Accessed December 5th, 2016.
Definition / General
  • Ovarian cyst > 3 cm in diameter, lined by luteinized granulosa and theca cells
  • If < 3 cm, it is called cystic corpus luteum, considered physiologic
Essential Features
  • Cyst over 3 cm in size
  • Cyst lining composed of luteinized granulosa cells and outer layer of theca cells
Terminology
  • Cystic corpus luteum arbitrarily defined if < 3 cm; corpus luteum cyst if > 3cm
  • Overlaps with the concept of hemorrhagic corpus luteum, which often becomes cystic
Epidemiology
  • Functional cysts in women of reproductive age, including pregnancy
  • Rare in postmenopausal women
Pathophysiology
  • Corpus luteum fails to regress following the release of an ovum and becomes cystically enlarged with fluid / blood
Clinical Features
  • Patients present with menstrual irregularities, amenorrhea, abdominal pain, palpable abdominal mass
  • If cyst ruptures, patient may present with acute abdomen and hemoperitoneum
Diagnosis
  • On pelvic ultrasound, appears as simple hemorrhagic ovarian cyst; incidental finding or diagnosed during symptomatic workup
Prognostic Factors
  • Most hemorrhagic cysts resolve by 8 weeks; persistent simple cysts > 5 cm in diameter are generally benign and may be monitored without intervention to ensure resolution
  • In postmenopausal women consider surgical evaluation of hemorrhagic cysts, as the etiology is more likely neoplastic than functional (Radiology 2010;256:943)
  • The vast majority of pregnancy associated simple cysts less than 5 cm resolve by weeks 16 - 20 and require no intervention (Clin Obstet Gynecol 2006;49:492)
Case Reports
Treatment
  • Resection if symptomatic
  • For asymptomatic unilocular cysts with normal CA 125, optimal management includes surveillance with ultrasound (Clin Obstet Gynecol 2006;49:506)
Gross Description
  • Single unilocular cyst
  • Cyst wall and lining is yellow; the cyst is typically filled with blood
Gross Images

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Cyst is full of blood, probe at bottom right indicates point of rupture (AFIP)

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Wall is thick and yellow and lining is smooth (AFIP)



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Ovarian corpus luteum (Ovarian luteal cyst)


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Corpus luteum

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Ovary with two corpora lutea

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Corpus luteum cyst

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Hemorrhagic corpus luteum

Micro Description
  • Cyst lining is convoluted, composed of luteinized granulosa cells and outer layer of theca cells
  • Prominent inner layer of fibrous tissue
Micro Images

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Layer of luteinized granulosa
cells with abundant cytoplasm
overlying small theca cells (AFIP)


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Hemorrhagic corpus luteum

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Corpus luteum cyst with hemorrhage

Differential Diagnosis
  • Cystic granulosa cell tumor
  • Endometriotic cyst endometrial glands and stroma, hemosiderin laden macrophages are present in the cyst wall
  • Epithelial inclusion cyst lined by either ciliated (tubal type) or flat (ovarian surface / peritoneal type) epithelium
  • Follicular cyst:
    • > 3 cm: lined by an inner layer of granulosa cells and an outer layer of theca cells
    • < 3 cm: termed a cystic follicle
    • Luteinization is either absent or only focal (not diffuse as in corpus luteum cyst)