Ovary
Other nonneoplastic
Corpus luteum cyst
Topic Completed: 1 November 2016
Minor changes: 31 December 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: Corpus luteum cyst[title]
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 January 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
AFIP images
Cyst is full of blood,
probe at bottom
right indicates
point of rupture
Wall is thick and yellow and lining is smooth
Images hosted on other servers:
Ovarian corpus luteum (Ovarian luteal cyst)
Corpus luteum
Ovary with two corpora lutea
Corpus luteum cyst
Hemorrhagic corpus luteum
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
AFIP images
Layer of luteinized granulosa cells
Images hosted on other servers:
Hemorrhagic corpus luteum
Corpus luteum cyst with hemorrhage
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)
