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Ovary-nontumor

Non-neoplastic cysts / other

Hyperreactio luteinalis

Reviewer: Mohiedean Ghofrani, M.D. (see Reviewers page)
Revised: 9 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Bilateral, ovarian enlargement due to multiple, luteinized follicle cysts

Epidemiology
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● Rare
● Associated with hydatidiform mole, choriocarcinoma, fetal hydrops due to Rh sensitization and multiple gestations
● Rarely seen in uncomplicated, single pregnancy

Etiology
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● Due to hCG stimulation or hypersensitivity to hCG

Clinical features
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● Usually no symptoms, may have pain from hemorrhage; rarely ascites
● Virilization in 15% of mothers, but not female infants in cases without gestational trophoblastic disease

Prognostic factors
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● Only rarely recurs (J Clin Pathol 2005;58:439)

Case reports
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● Associated with HELLP syndrome (Fertil Steril 2008;90:2008 e13)
● With hirsutism (Gynecol Endocrinol 2007;23:248)
● With marked virilization and hyperglycemia (Am J Perinatol 2006;23:85)

Treatment
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● Cysts typically involute within 6 months (Arch Pathol Lab Med 1989;113:921)
● Operate only to remove infarcted tissue or to control hemorrhage

Gross description
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● Multiple, bilateral thin-walled cysts, filled with clear or hemorrhagic fluid

Gross images
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Both ovaries are enlarged by multiple thin-walled cysts (AFIP)

Micro description
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● Follicular cysts with luteinization of theca interna or granulosa cells, edema of theca layer and stroma

Micro images
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Two cysts are lined by luteinized granulosa cells overlying luteinized theca cells (AFIP)


There is prominent edema in the luteinized theca cell layer (AFIP)


The ovarian stroma is markedly edematous (AFIP)

End of Ovary-nontumor > Non-neoplastic cysts / other > Hyperreactio luteinalis

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