Ovary
Other nonneoplastic
Polycystic ovary disease
Author: Shahid Islam, M.D., Ph.D.
Topic Completed: 1 June 2012
Minor changes: 12 July 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Polycystic ovary disease [title]
Table of Contents
Definition / general | Treatment (for infertility) | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Videos | Additional referencesCite this page: Islam S. Polycystic ovary disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovaryPCO.html. Accessed August 3rd, 2020.
Definition / general
- Formerly called Stein-Leventhal syndrome
- Affects 5 - 10% of women in US; 3 - 15% women of reproductive age; most common cause of anovulatory infertility
- Occurs during teenage and childbearing years
- Associated with endometrial hyperplasia, well differentiated adenocarcinoma
- Also acne, obesity, hirsutism, insulin resistance and diabetes
- Endometrium may show metaplastic changes resembling adenoacanthoma or adenocarcinoma (Am J Surg Pathol 1982;6:223)
Two different diagnostic criteria:
- NIH: androgen excess, oligoovulation and exclusion of other entities that cause polycystic ovaries
- ESHRE / ASRM in Rotterdam (2 of 3 present):
- Oligoovulation or anovulation
- Excess androgen activity
- Polycystic ovaries present (by ultrasound) but no other endocrine disorders
Treatment (for infertility)
- Clomiphene citrate or FSH, weight loss
- Also ovarian drilling puncture of small follicles with electrocautery (Hum Reprod 2002;17:2851) although effectiveness has been questioned (Cochrane Database Syst Rev 2007;(3):CD001122)
- Formerly did wedge resections
Gross description
- Large ovaries (2x normal), numerous subcortical cysts (cysts may be immature follicles)
Gross images
AFIP images
Enlarged ovary is
pearly white, multiple
cysts are visible
beneath the surface
Microscopic (histologic) description
- Multiple cystic follicles covered by a dense fibrous capsule
- Luteinization of the theca interna (hyperthecosis), few corpora lutea or corpora albicantia since anovulatory, atretic follicles simulate corporate albicantia
Microscopic (histologic) images
AFIP images
Outer cortex is
collagenized with
several follicle cysts
arrayed beneath it
Prominent band of luteinized
theca cells surrounds the
cavity of an atretic follicle
(follicular hyperthecosis)
Videos
Histopathology ovary - polycystic ovarian disease
