Home > Ovary > Anatomy & histology
Ovary
General
Anatomy & histology

Mohiedean Ghofrani, M.D.

Topic Completed: 1 December 2011

Minor changes: 14 October 2020

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Normal histology ovary

Mohiedean Ghofrani, M.D.
Page views in 2020: 15,039
Page views in 2021 to date: 811
Table of Contents
Anatomy | Histology | Diagrams / tables | Case reports | Clinical images | Gross images | Microscopic (histologic) images | Positive stains | Negative stains | Videos | Additional references
Cite this page: Ghofrani M. Anatomy & histology. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumornormalhistology.html. Accessed January 22nd, 2021.
Anatomy
  • Paired ovoids on either side of the uterus close to lateral pelvic wall, behind broad ligament, anterior to rectum

    Each ovary is connected:
  • Along its anterior (hilar) margin to posterior aspect of broad ligament by mesovarium (double fold of peritoneum)
  • At its medial pole to ipsilateral uterine cornu by utero-ovarian ligament
  • At superior aspect of lateral pole to lateral pelvic side wall by infundibulopelvic (suspensory) ligament

  • Premenopausal ovaries are each 3 - 5 cm long and weigh 5 - 8 g; size and weight depends on amount of follicular derivatives (cysts and corpora albicantia / lutea); shrink to about half their size after menopause
  • Neonates often have cysts, which resolve spontaneously (J Pediatr Endocrinol Metab 2007;20:397)
  • Pink white exterior is initially smooth but gradually becomes more convoluted
  • Cystic follicles and corpora lutea may be visible from outside
  • Cut section may exhibit three zones: cortex, medulla and hilus, with follicular derivatives usually in the cortex and medulla
  • Arterial supply: approximately 10 arterial branches from anastomotic arcade of ovarian artery (branch of aorta) and ovarian branch of uterine artery penetrate hilus into medulla and cortex
  • Venous drainage: left ovarian vein drains to left renal vein, right ovarian vein drains to inferior vena cava
  • Lymphatic drainage: originates predominantly from theca layer of follicles, exiting through the hilus, to the mesovarium, along the infundibulopelvic ligament, into upper paraaortic lymph nodes; may bypass to internal iliac, external iliac, common iliac, sacral, obturator, pelvic, retroperitoneal or inguinal nodes
  • Function first described by Reinier de Graaf (Arch Pathol Lab Med 2000;124:1115)
  • Ovulation: induces cyclic rupture and regenerative repair of the ovarian surface epithelium
Histology
  • Ovaries are covered by surface epithelium (OSE), which is a modified mesothelium, also called coelomic or germinal epithelium (Reprod Biol Endocrinol 2006;4:42)
  • OSE is one layer of flat to cuboidal mesothelial type cells, which appear to actively participate in the ovulatory rupture and repair process
  • OSE is closely related to Müllerian duct lining epithelium
  • Stroma: comprises bulk of ovarian tissue; resembles fibroblasts in whorls / storiform pattern surrounded by dense reticulin network; contains luteinized stromal cells, decidual cells, smooth muscle, fat, neuroendocrine cells and endometrial stroma-like cells
  • Follicles: ~400K primordial follicles containing primary oocytes are present at birth in ovarian stroma (100K at gestational age 15 weeks, 680K at 8 months, Fertil Steril 2007;88:675)
  • Follicular decay appears to advance with increasing age (Hum Reprod 2008;23:699); prominent cystic follicles present at birth and at puberty
  • Postmenopausal ovary has thick walled medullary and hilar vessels, also granulomata and hyaline scars

    Stages of follicular development:
    • Primordial follicle: travels from yolk sac endoderm to ovary, develops into oogonia and oocytes, arrests at prophase of mitosis; neo-oogenesis may occur in adults (Endocrine 2005;26:301)
    • Maturing follicle: oocyte with surrounding granulosa cell layer; lacks reticulum; contains Call-Exner bodies (rosette-like formations with central filamentous / eosinophilic material consisting of excess basal lamina) and theca cells (within follicle are luteinized and produce sex hormones, external to follicle are very cellular)
    • Corpus luteum: 2 cm, round, yellow, lobulated structure with cystic center; has luteinized granulosa and theca cells; in pregnancy is larger, bright yellow with prominent central cavity, hyaline droplets and calcification
    • Corpus albicans: remnant of corpus luteum

  • Hilus (hilar) cells: located in ovarian medulla, rarely within ovarian stroma; located away from the hilum, round to polygonal, epithelial appearing, presumed vestigial remnant of gonad from its "ambisexual" phase
  • Produce steroids (predominantly androstenediaone); resemble Leydig cells of testis; may produce masculinizing tumors (hilus cell tumors)
  • Closely associated with large hilar veins and lymphatics and may protrude within their lumina; also associated with nerves
  • May contain Reinke crystalloids, lipid, lipochrome pigment
  • Resemble steroid cells by EM with microtubular smooth endoplasmic reticulum, mitochondria with tubular cristae
  • Hilar cells are seen in the fetal ovary but not in infancy and childhood; they reappear at puberty
  • Hilar cell hyperplasia: associated with hCG administration, pregnancy, choriocarcinoma
  • Rete ovarii: counterpart of rete testis, seen as clefts, tubules, cysts, papillae lined by epithelium, surrounded by spindle cell stroma
  • Walthard cell nests: usually microscopic cystic / solid structures with urothelial type epithelium and variable mucin seen in mesovarium, mesosalpinx and ovarian hilus
    • Diagrams / tables

    AFIP images

    Drawing



    Images hosted on other servers:
     

    Drawings

    Section of the ovary

    Case reports
    Clinical images

    Images hosted on other servers:

    Ovary about to release an egg

    Gross images

    Images hosted on other servers:
     

    Corpus luteum

    Cystic

    With follicular cysts

    Microscopic (histologic) images

    Scroll to see all images:

    AFIP images

    Follicles:

    Primordial follicles and primary follicles

    Secondary follicle

    Graafian follicle

     

    Mature follicles

    Granulosa cells of
    proliferating follicle
    exhibit marked
    mitotic activity



    Normal histology:

    Surface epithelium

    Surface epithelial stromal proliferation

    Vacuolar change within surface epithelial inclusion glands

     

    Surface epithelial inclusion glands

    Ovarian stroma


    Luteinized stromal cells

     

    Hilus cells

     

    Rete ovarii

    Walthard nest



    Corpus luteum:

    Of menstruation

    Involuting at menstruation

     

    Corpus luteum of pregnancy



    Pregnancy related changes:
     

    Granulosa cell proliferation

     

    Ectopic decidua



    Miscellaneous:
       

    Mesothelial hyperplasia

    Adrenocortical rest in mesosalpinx

     

    Artifact: granulosa cells in blood vessel lumina


    Postmenopausal: atrophic ovary

    Postmenopausal: cortical granuloma

    Infarcted appendix
    epiploica attached to
    ovarian surface, with
    focal calcification

    Nodular hilar cell proliferation

     

    Hilus cell hyperplasia

    Positive stains
    Negative stains
    Videos

    Corpus luteum

    Corpus albicans

    Back to top
    Home > Ovary > Anatomy & histology
    Image 01 Image 02