Other nonneoplastic
Follicular cysts

Topic Completed: 1 August 2011

Minor changes: 12 February 2021

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PubMed Search: Ovarian follicular cysts [title]

Mohiedean Ghofrani, M.D.
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Cite this page: Ghofrani M. Follicular cysts. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorfollicularcysts.html. Accessed March 3rd, 2021.
Definition / general
  • Benign, ovarian cyst measuring at least 3 cm and lined by granulosa and theca interna cells
  • If < 3 cm, termed a cystic follicle; if > 3 cm, termed a follicular cyst
  • Follicular cyst is common in reproductive years
  • Ovarian follicle matures during proliferative phase of menstrual cycle, then LH surge causes release of mature oocyte at midcycle, then follicle transforms to a corpus luteum
  • If no fertilization, corpus luteum typically atrophies, eventually forming a corpus albicans
  • If no LH surge or no ovulation, follicle grows and becomes a cyst, which usually disappears within 2 - 3 menstrual cycles but may persist
Clinical features
  • Usually asymptomatic or forms an adnexal mass
  • Pedicle may twist and cause hemorrhagic infarction
  • Associated with precocious puberty in children
  • May be multiple when a component of McCune-Albright syndrome (polyostotic fibrous dysplasia, cutaneous melanin pigmentation and endocrine organ hyperactivity)
Case reports
Gross description
  • Rarely greater than 8 cm
  • Glistening membrane
  • Thin walled
  • Unilocular or multilocular
  • Clear or serous fluid contents
  • No solid component
Gross images

AFIP images

A unilocular cyst has a smooth lining

Images hosted on other servers:

Follicular cyst

Large follicular cysts

Follicular cysts and corpus luteum

Microscopic (histologic) description
  • Outer layer of theca interna cells, usually luteinized and may be surrounded by reticulum
  • Variable inner layer of granulosa cells, luteinized after puberty
Microscopic (histologic) images

AFIP images

Cyst is lined by luteinized granulosa cells overlying luteinized theca cells

Images hosted on other servers:

Epithelial lining

Theca lutein cyst

Inhibin stain

Cytology description
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