Cytology of nonneoplastic cysts of the ovary

Abstract

From March 1986 through September 1988, cytologic material from 13 nonneoplastic ovarian cysts collected at the time of surgical removal of the ovary was compared with the histologic follow-up of these lesions in an attempt to characterize the cytologic features of benign ovarian cysts. In 22 additional nonneoplastic cysts, cellular material was obtained by the clinician with fine-needle aspiration. The 32 patients ranged in age from 18 to 64 yr (mean, 36.8; median, 35.5); of these, 24 were premenopausal, 6 were perimenopausal, and 2 were postmenopausal. Cytologically, follicular cysts (two cases) showed clusters of granulosa cells, some containing mitotic figures. Luteinized follicular cysts (11 cases) were composed of granulosa cells admixed with luteinized granulosa cells. Hemorrhagic corpora lutei (five cases) were characterized by fresh blood containing hemosiderin-laden macrophages and luteinized granulosa cells. Hemorrhagic corpus luteal cysts (10 cases) showed the presence of luteinized granulosa cells, fibroblasts, hemosiderin-laden macrophages, fresh blood, and abundant fibrin. In addition to these findings, regressing corpora lutei (two cases) contained macrophages with yellow hematoidin pigment. Endometriotic cysts (three cases) were composed of fresh blood, hemosiderin-laden macrophages, and scattered endometrial cells. In two cysts, subclassification was not possible due to scanty cellularity. An understanding of the cytologic features of nonneoplastic ovarian cysts may encourage aspiration as opposed to surgical ovarian removal. This has important implications, particularly in women of child-bearing age who wish to preserve their fertility.

Fine Needle Aspiration Cytology of an Ovarian Luteinized Follicular Cyst Mimicking a Granulosa Cell Tumor

“…[9][10][11][12] Nuclear grooves have been reported to be of value in the diagnosis of granulosa cell tumors 10 but have been observed in follicular cysts and maturing follicles. 6 Our case supports that observation.…”

“…Nuclear grooves were present in several cells. 6 In our case dispersed cells predominated, and abundant cytoplasm was missing. These features have been reported as characteristic of granulosa cell tumors.…”

Value of ultrasound-guided fine-needle aspiration in the management of ovarian and paraovarian cysts

“…Cytologic examination of cyst fluids, as reported by others, 10,11 is an efficient routine technique that contributed to diagnosing 54.9% of our lesions, whereas in 37.7% of cases no diagnosis was possible because of an acellular cytology or the exclusive presence of macrophages and degenerated cells. Paraffin-embedding of the pellet in case of abundant aspirates must be recommended, because it is sometimes the only way that leads to final diagnosis.…”

CA-125 and Carcinoembryonic Antigen Assay vs. Cytodiagnostic Experience in the Classification of Benign Ovarian Cysts

“…3,6,7,9 The reported frequency of nondiagnostic ovarian cyst aspirates varies from 5% to 47%. 3,4,10,16,18 False negative and nondiagnostic interpretations for carcinoma have been reported even by experienced and expert pathologists [2][3][4][5][6][7][9][10][11]14,16 (Table IV). While the presence of mucin, cilia and keratinized squames aids in the classification of epithelial cysts, often these readily recognized features are lacking.…”