Table of Contents
Definition / general | Essential features | Terminology | Epidemiology | Pathophysiology | Clinical features | Diagnosis | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Busca A, Parra-Herran C. Corpus luteum cyst. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorcorpuslutcyst.html. Accessed April 18th, 2021.
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
- 15 year old girl with ruptured corpus luteum cyst of pregnancy with massive hemoperitoneum (J Pediatr Adolesc Gynecol 2007;20:97)
- 16 year old girl with hemoperitoneum from corpus luteum cyst rupture (Case Rep Emerg Med 2014;2014:252657)
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
Microscopic (histologic) description
- Cyst lining is convoluted, composed of luteinized granulosa cells and outer layer of theca cells
- Prominent inner layer of fibrous tissue
Microscopic (histologic) images
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)