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Ovary - nontumor

Non-neoplastic cysts/other

Stromal hyperplasia

Reviewer: Shahid Islam, M.D., (see Reviewers page)
Revised: 5 June 2012, last major update May 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.


● Varying degrees of proliferation of ovarian stromal cells, potentially mimicking a neoplasm, but without luteinization (stromal hyperthecosis refers to presence of luteinized cells in the stroma at a distance from the follicles)
● Less frequently estrogenic or androgenic than stromal hyperthecosis
● Patients may be obese, have hypertension or abnormal glucose tolerance

Gross description

● Almost invariably bilateral, ill defined, homogeneous white-yellow nodules in ovary
● May lead to enlarged ovary

Gross images

Ill-defined, pale yellow tissue occupies the center of the ovary

Micro description

● Medullary or occasionally cortical clusters of densely cellular ovarian stroma with scant collagen
● May entirely replace ovarian architecture
● No luteinized stromal cells, but the cells are often plumper than normal post-menopausal stromal cells
● No mitotic figures

Micro images

The ovarian medulla and cortex of an elderly woman are replaced by cellular stroma

Confluent nodules of hyperplastic stroma occupy the medulla

Differential diagnosis

● Stromal hyperthecosis (luteinized cells), low grade endometrial stromal sarcoma (spiral arterioles and mitotic figures present)
● Fibroma (unilateral or bilateral, cells have larger nuclei)

End of Ovary - nontumor > Non-neoplastic cysts/other > Stromal hyperplasia

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