Ovary
Tumor-like lesions
Hyperreactio luteinalis
Author: Mohiedean Ghofrani, M.D.
Last author update: 1 August 2011
Last staff update: 16 October 2020
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Hyperreactio luteinalis
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Ghofrani M. Hyperreactio luteinalis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorhyperreactio.html. Accessed April 18th, 2024.
Definition / general
- Bilateral, ovarian enlargement due to multiple, luteinized follicle cysts
Epidemiology
- Rare
- Associated with hydatidiform mole, choriocarcinoma, fetal hydrops due to Rh sensitization and multiple gestations
- Rarely seen in uncomplicated, single pregnancy
Etiology
- Due to hCG stimulation or hypersensitivity to hCG
Clinical features
- 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
- Only rarely recurs (J Clin Pathol 2005;58:439)
Case reports
- 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
- 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
- Multiple, bilateral thin walled cysts, filled with clear or hemorrhagic fluid
Gross images
AFIP images
Both ovaries are
enlarged by
multiple thin
walled cysts
Microscopic (histologic) description
- Follicular cysts with luteinization of theca interna or granulosa cells, edema of theca layer and stroma
Microscopic (histologic) images
AFIP images
Luteinized granulosa cells
Prominent edema
in the luteinized
theca cell layer
Ovarian stroma is markedly edematous
