Ovarian cyst

Author: Mikael Häggström

Presentations

Typically a cyst with more or less of the ovary.

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

• Minimal depth
• (Moderate depth)
• ((Comprehensive))

Other legend

<< Decision needed between alternatives separated by / signs >>
{{Common findings / In case of findings}}
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Gross processing

Transillumination may help in identifying thickened areas of the cyst. This example also shows papillary excrescences near the bottom.

The specimen is generally not inked.

Gross report

Example:

(Labeled - ___.) The specimen is received in formalin and consists of an ovary with a cyst, and attached portion of the fallopian tube, in total measuring ___. The capsule of the ovary and the cyst is tan-pink and smooth. The cyst is << intact / collapsed>>{{, with a wall defect measuring _ cm}}. Upon {{further}} opening the contents of the cyst consists of ___. The cyst lining is tan-pink and smooth, with a wall thickness of __. There are no papillary excrescences. Cut sections of the ovary reveal solid, white and whorled parenchyma, and no gross lesions. The attached fallopian tube fragment measures ___, and displays fimbria. Cut sections of the tube reveal a patent lumen. Representative sections are submitted for microscopic examination in __ cassettes.

Microscopic evaluation

If there are solid components, evaluate those as ovarian tumors.

Attempt to classify cysts into either of the following:

Type	Subtype	Typical microscopy findings	Image
Functional cyst	Follicular cyst	A variable inner layer of granulosa cells which are luteinized after puberty An outer layer of usually luteinized theca interna
	Corpus luteum cyst	A convoluted cyst lining of luteinized granulosa cells A prominent fibrous to hemorrhagic inner layer An outer layer of theca cells
Cystadenoma	Serous cystadenoma	Cyst lining consisting of a simple epithelium, whose cells may be either: columnar and tall and contain cilia, resembling normal tubal epithelium cuboidal and have no cilia, resembling ovarian surface epithelium
	Mucinous cystadenoma	Lined by a mucinous epithelium
Mature cystic teratoma (dermoid)		Well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).
Endometriosis		At least two of the following three criteria: Endometrial type stroma Endometrial epithelium with glands Evidence of chronic hemorrhage, mainly hemosiderin deposits
Borderline tumor		Atypical epithelial proliferation without stromal invasion.
Ovarian cancer		Many different types, but generally severe dysplasia/atypia and invasion.	Serous carcinoma.
Simple cyst / simple squamous cyst		Simple squamous epithelium and not conforming to diagnoses above

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