Ovary
Other nonneoplastic
Pregnancy luteoma
Author: Shahid Islam, M.D., Ph.D.
Topic Completed: 1 June 2012
Minor changes: 5 May 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Pregnancy luteoma ovary
Table of Contents
Definition / general | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy description | Differential diagnosisCite this page: Islam S. Pregnancy luteoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarypregnancyluteoma.html. Accessed August 6th, 2020.
Definition / general
- Single or multiple nodules of luteinized cells with abundant eosinophilic cytoplasm, detected during pregnancy
- Rare (100 cases described), probably hyperplasia due to hCG, not neoplasia
- 80% in multiparous women, 80% in blacks
- Usually an incidental finding at cesarean section or postpartum tubal ligation
- 25% are associated with virilization in latter half of pregnancy, 2/3 of female infants of virilized mothers are virilized (note: usually placenta aromatizes androgens to estrogens); testosterone levels are 70x normal, elevated even in nonvirilized patients
Case reports
- 33 year old woman with luteoma presenting as ovarian torsion with rupture and intra-abdominal bleeding (Singapore Med J 2008;49:e78)
- 34 year old woman with prenatal diagnosis of female pseudohermaphroditism associated with bilateral luteoma of pregnancy (Hum Reprod 2002;17:821)
Treatment
- None - tumors are benign and regress weeks after delivery (infarct like necrosis leads to scar)
Gross description
- Soft, fleshy, circumscribed, yellow / orange nodules, hemorrhagic, may be very large
- 1/3 bilateral, 1/2 multiple, may see separate corpus luteum
Gross images
Images hosted on other servers:
Bilaterally enlarged ovaries
Multicentric and bilateral tumor
Microscopic (histologic) description
- Sharply circumscribed, rounded masses of polygonal cells with abundant pink cytoplasm containing little lipid (theca - lutein cells), round nuclei, variably prominent nucleoli, mild nuclear atypia
- 2 - 3 MF/10 HPF, scant stroma; may have colloid filled spaces
Microscopic (histologic) images
AFIP images
Several follicle-like spaces are present
Cells have abundant
eosinophilic cytoplasm
and regular, round nuclei
with prominent nucleoli
Two mitotic figures are visible
Images hosted on other servers:
Various images
Positive stains
Electron microscopy description
- Smooth ER, dispersed Golgi, tubular cristae in mitochondria (associated with steroid hormone producing cells)
Differential diagnosis
- Corpus luteum of pregnancy: central cavity, convoluted border, cells have hyaline or calcified bodies
- Granulosa cell tumor
- Hyperreactio luteinalis: bilateral enlargement of ovaries, multiple luteinized follicle cysts, associated with increased hCG levels; e.g. in GTD, multiple gestations, fetal hydrops
- Large solitary luteinized follicular cyst of pregnancy and puerperium
- Melanoma: pigment present, S100+, HMB45+, alpha inhibin negative
- Steroid cell tumor (not usually in pregnant women, usually unilateral, more nonluteinized foci, more lipid, more nuclear atypia)
- Thecoma
