Ovary
Other nonneoplastic
Corpus luteum cyst


Topic Completed: 17 June 2021

Minor changes: 17 June 2021

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PubMed Search: Corpus luteum cyst[TIAB] full text[SB]

Aurelia Busca, M.D., Ph.D.
Carlos Parra-Herran, M.D.
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Cite this page: Busca A, Parra-Herran C. Corpus luteum cyst. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorcorpuslutcyst.html. Accessed July 28th, 2021.
Definition / general
  • Ovarian cyst > 3 cm in diameter, lined by luteinized granulosa and theca cells
Essential features
  • Cyst over 3 cm in size
  • Cyst lining composed of inner layer of luteinized granulosa cells and outer layer of theca cells
ICD coding
  • ICD-11: GA18.1 - Corpus luteum cyst
Epidemiology
  • Functional cysts in women of reproductive age, including pregnancy
  • Rare in postmenopausal women
Sites
  • Ovary
Pathophysiology
Clinical features
  • Patients can be asymptomatic or present with menstrual irregularities, amenorrhea, abdominal pain, palpable abdominal mass if large size
  • If cyst ruptures, patient may present with acute abdomen and hemoperitoneum
  • Reference: Turk J Obstet Gynecol 2020;17:300
Diagnosis
  • On pelvic ultrasound, appears as simple ovarian cyst, often hemorrhagic; incidental finding or diagnosed during symptomatic workup
Laboratory
  • No specific laboratory findings
Radiology description
  • On ultrasound: unilocular cyst with prominent peripheral blood flow and thick crenulated vascular walls
  • On CT: unilocular structure with crenulated walls and brisk enhancement (Abdom Radiol (NY) 2016;41:2270)
Radiology images

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CT: ruptured corpus luteum cyst and hemoperitoneum

CT: ruptured corpus luteum cyst and hemoperitoneum

Prognostic factors
  • Most cysts resolve spontaneously
  • Hemorrhagic cysts over 5 cm or simple cysts between 5 and 7 cm in women of reproductive age require follow up to ensure resolution (Ultrasound Q 2010;26:121)
  • In postmenopausal women, consider surgical evaluation of hemorrhagic cysts, as the etiology is more likely neoplastic than functional (Radiology 2010;256:943)
  • Vast majority of pregnancy associated simple cysts < 5 cm resolve by weeks 16 - 20 and require no intervention (Clin Obstet Gynecol 2006;49:492)
Case reports
Treatment
Clinical images

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Intraoperative: hemorrhage of corpus luteum cyst

Intraoperative: hemorrhage of corpus luteum cyst

Gross description
Gross images

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Ovarian corpus luteum cyst

Ovarian corpus luteum cyst

Missing Image

Corpus luteum cyst

Frozen section description
  • Convoluted cyst wall lined by cells with abundant eosinophilic cytoplasm and bland nuclear features
  • Cytoplasm may appear vacuolated on frozen tissue
Microscopic (histologic) description
  • Cyst lining is convoluted, composed of an inner layer of luteinized granulosa cells and outer layer of theca cells
  • Granulosa cells are polygonal in shape, with abundant eosinophilic cytoplasm and central round nuclei
  • Mitotic figures may be seen in the granulosa cells
  • Outer theca cells are smaller in size
  • Prominent inner layer of fibrous tissue
  • Reference: Kurman: Blaustein's Pathology of the Female Genital Tract, 7th Edition, 2019
Microscopic (histologic) images

Contributed by Aurelia Busca, M.D., Ph.D.
Convoluted cyst lining

Convoluted cyst lining

Bilayered cyst lining

Bilayered cyst lining

Granulosa and theca cells Granulosa and theca cells

Granulosa and theca cells

Reticulin stain

Reticulin stain

Virtual slides

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Corpus luteum cyst

Corpus luteum cyst

Cytology description
  • Rarely performed
  • Luteinized granulosa cells and hemosiderin laden macrophages in the background of blood and fibrin (Diagn Cytopathol 1990;6:77)
Positive stains
Negative stains
Sample pathology report
  • Ovary, right, cystectomy:
    • Corpus luteum cyst
    • Background ovary with cystic follicles and epithelial inclusion cysts
    • Negative for malignancy
Differential diagnosis
  • Cystic granulosa cell tumor:
    • Usually larger
    • The 2 cell types in the cyst wall have a more disorderly pattern
    • Neoplastic cells can infiltrate the cyst wall
    • With or without Call-Exner bodies
  • Endometriotic cyst:
    • Endometrial glands and stroma, hemosiderin laden macrophages
  • 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
    • Luteinization is either absent or only focal
    • Lacks the convoluted appearance on low power magnification
  • Cystic corpus luteum:
    • Size < 3 cm
Board review style question #1

Which of the following is true about the 4 cm ovarian cyst shown in the image above?

  1. Affects predominantly postmenopausal women
  2. It is a benign finding, expected to undergo regression
  3. It is a precursor lesion for granulosa cell tumor
  4. It is lined by a single layer of granulosa cells
Board review style answer #1
B. It is a benign finding, expected to undergo regression

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Reference: Corpus luteum cyst
Board review style question #2
Which of the following is characteristic of a corpus luteum cyst of the ovary?

  1. Bilayered lining of granulosa and theca cells
  2. Presence of endometrial type stroma
  3. Single layer of ciliated cells with eosinophilic cytoplasm
  4. Single layer of granulosa cells
Board review style answer #2
A. Bilayered lining of granulosa and theca cells

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Reference: Corpus luteum cyst
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