ovary





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  • Normal

    • cortex
      • epithelium
        • simple columnar
      • follicles
      • corpus luteum
        • mature corpus luteum: pink granulosa-lutein cells
        • degenerating corpus luteum: white granulosa-lutein cells filled with lipid
        • corpus albicans
        • corpus luteum of pregnancy
      • stroma
        • plump spindle cells
        • luteinized cells
          • polygonal, eosinophilic to clear cytoplasm, round central nucleus with prominent nucleoli
    • medulla
      • stroma: same as cortex stroma
      • blood vessels
    • hilus
      • rete ovarii
      • leydig-like cells
  • Non-neoplastic

    • Cysts
      • Corpus luteum cyst
        • prominent connective tissue
      • follicular cyst
        • granulosa cell inner lining
        • theca cell outer lining
      • epidermal inclusion cyst
        • statified squamous lining with granular layer
        • Filled laminated keratin
        • vs trichilemmal cyst: no granular layer, compact wet keratin)
      • peritoneal inclusion cyst
      • Walthard nest
      • endosalpingiosis
      • PCOD
        • multiple cortical cysts
      • PCOS
      • hyperreactio luteinalis
    • endometriosis
    • Walthard nest
    • Inflammation
    • Hyperplasia
      • stromal hyperplasia and hyperthecosis
      • granulosa cell prolif of pregnancy
      • hilar leydig cell hyperplasia
    • Metaplasia
      • decidua
      • smooth muscle metaplasia
    • Heterotopia
      • endometriosis
      • nests of endometrial stromal cells
      • leydig cells
        • Reinke crystals
      • neuroendocrine cells
      • spleen
      • prostate
      • adrenal rest
    • Others
      • luteoma of pregnancy
      • cortical granuloma
      • hyaline scar
      • papillary stromal projections
      • serous surface papilloma
      • mesothelial cell hyperplasia
        • response to PID
        • can be florid tubulopapillary, pseudoinfiltrative, nuclear atypia
        • ddx mesothelioma
  • epithelial tumors

  • germ cell tumors

  • sex cord stromal tumors

  • Other neoplasms

    • Mixed GCT-SCT
    • rete ovarii
      • adenocarcinoma
      • adenoma
      • cystadenoma
      • cystadenofibroma
    • dermoid cyst-associated
      • carcinoma
        • SCC
        • adenocarcinoma
      • sebaceous
        • sebaceous adenoma
        • sebaceous carcinoma
      • sarcoma
      • melanocytic
        • melanoma
        • nevus
    • misc tumors
      • neuroendocrine
        • small cell carcinoma
        • large cell neuroendocrine carcinoma
      • hepatoid carcinoma
      • mesothelioma
      • Wilms tumor
      • GTDs
        • gestational choriocarcinoma
        • hydatidiform mole
      • adenoid cystic carcinoma
      • basal cell tumor
      • ovarian wolffian tumor
      • paraganglioma
      • myxoma
      • soft tissue
    • tumor-like conditions
      • luteoma of pregnancy
      • stromal hyperthecosis
      • stromal hyperplasia
      • fibromatosis
      • massive ovarian edema
    • hematolymphoid
      • lymphoma
      • plasmacytoma
    • peritoneal
  • TNM (useful for grossing)

    • T1: limited to ovary(s)
      • T1a: unilateral
      • T1b: bilateral
      • T1c: tumor ruptured, on surface, or in peritoneal fluid
    • T2: pelvic involvement
      • T2a: uterus or tube involvement
      • T2b: other pelvic tissue involvement
      • T2c: malignant peritoneal fluid
    • T3: peritoneal involvement or N1
      • T3a: microscopic only
      • T3b: <= 2cm
      • T3c: > 2cm or N1
  • Staging

    • I: T1
      • IA: T1a
      • IB: T1b
      • IC: T1c
    • II: T2
      • IIA: T2a
      • IIB: T2b
      • IIC: T2c
    • III: T3 or N1
      • IIIA: T3a
      • IIIB: T3b
      • IIIC: T3c or N1
    • IV: M1