Cases reported "Ovarian Cysts"

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1/13. Vascular embolization of benign granulosa cells.

    OBJECTIVE(S): Most conditions involving sex cord-stromal cells can be diagnosed on morphologic criteria alone. We describe a case of vascular embolization of benign granulosa cells in which immunohistochemistry was of value as a diagnostic tool. methods: We reviewed the clinical history and gross pathologic findings from a 48-year-old patient who presented with abdominal pain and fullness. Formalin-fixed paraffin-embedded sections were examined by routine H&E and immunohistochemical stains. RESULTS: Histologic examination of a grossly enlarged and cystic ovary revealed nests of cells within angiolymphatic spaces. Although the cells were cohesive and atypical, they were morphologically similar to the nearby graafian follicle. immunohistochemistry showed positive labeling with antibodies to inhibin-alpha and cytokeratin in a pattern consistent with benign granulosa cells. CONCLUSION(S): Immunohistochemical stains for inhibin-alpha and cytokeratin are useful tools to help confirm granulosa cell origin, as demonstrated in this case involving an atypical histomorphologic picture of "embolization." copyright 2000 Academic Press.
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ranking = 1
keywords = granulosa cell, granulosa
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2/13. Fetal ovarian cysts: a report of three cases managed by intrauterine aspiration.

    Small follicular or functional theca-lutein cysts are a common finding in fetal and neonatal ovaries. After delivery, decrease of hormonal stimulation may lead to spontaneous resolution of the cyst. A high rate of complication has been underlined by recent studies, the most common being ovarian torsion with subsequent loss of the ovary. Because torsion may happen with any size of cyst, however large or small, we suggest in utero decompression even in small fetal ovarian cysts (< 5 cm). We report here three cases of such cysts managed by intrauterine aspiration with good outcome and no further need for neonatal surgery. In all cases cytology of the cyst aspirate demonstrated numbers of granulosa cells and fluid biochemistry showed a high amount of estradiol, progesterone, and testosterone that confirmed the etiology as ovarian. Despite the small size of the cysts, no technical difficulties were encountered and no maternal or fetal morbidity occurred. Prenatal management of fetal ovarian cysts remains controversial, however, and our limited experience needs to be assessed on a larger number of cases.
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ranking = 0.14285714285714
keywords = granulosa cell, granulosa
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3/13. Ovarian hyperstimulation without elevated serum estradiol associated with pure follicle-stimulating hormone-secreting pituitary adenoma.

    We report a unique case of a 28-yr-old woman with a gonadotroph adenoma secreting FSH, presented with ovarian hyperstimulation, without elevation of serum estradiol. She presented with abdominal pain and large ovaries (both 10 cm in diameter) with multiple follicular cysts shortly after discontinuing oral contraceptive pills. She had a supranormal PRL level of 71 microg/liter (normal, <20), FSH of 8.4-9.2 IU/liter (normal for follicular phase, 2.4-10), LH of 0.01 IU/liter (normal, 1.6-9.3), estradiol of 108 pmol/liter (normal for follicular phase, 80-790), and free alpha-subunit level of 0.11 microg/liter (normal, <1.8). A nuclear magnetic resonance study revealed invasive pituitary macroadenoma, 30 mm in diameter. dopamine agonist (cabergoline) treatment normalized serum PRL but had no affect on FSH levels. A transsphenoidal surgery was performed, and most of the adenoma was resected. One month after surgery the patient resumed menstruation, and the hormonal profile included serum FSH of 6.3 IU/liter, LH of 2.1 IU/liter, estradiol of 156 pmol/liter, and PRL of 10 microg/liter. The excised adenoma tissue exhibited intense immunostaining for FSH and secreted this hormone to culture medium. Stimulation with TRH (both in vivo preoperatively and in vitro study of the excised tumor) had no effect on FSH secretion from the adenoma. estradiol did not suppress FSH release from cultured adenoma cells. Patient serum samples showed significant FSH bioactivity when tested in a human granulosa cell line. This case is remarkable because the ovarian hyperstimulation related to the FSH-secreting adenoma was not associated with high levels of serum estradiol, probably due to insufficient LH production by the normal pituitary. Thus, it supports the two-cell, two-gonadotropin theory, that both FSH and LH are necessary for normal ovarian estrogen production.
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ranking = 0.14285714285714
keywords = granulosa cell, granulosa
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4/13. Cystic adult ovarian granulosa cell tumor as a potential source of false negative diagnosis in ovarian cytology. A case report.

    BACKGROUND: adult granulosa cell tumors (AGCT), unilocular or multilocular, with thin-walled cysts, are extremely rare. They can be erroneously diagnosed as follicular cysts by sonography and fine needle aspiration and therefore may be a source of false negative results. CASE: laparoscopy was performed on a 29-year-old woman in whom a cystic ovarian mass, probably benign, was diagnosed by transvaginal sonography. The smears obtained from the cyst revealed a moderate amount of regular, small cells with scant cytoplasm and round to oval nuclei with finely granular chromatin without longitudinal grooves. These granulosa cells were arranged singly and in small groups. Very scarce cellular aggregates, microfollicular or rosettelike, some containing amorphous material and resembling Call-Exner bodies, were identified. Histologic study of the cystic wall confirmed the diagnosis of multilocular cystic AGCT with a microfollicular pattern. CONCLUSION: The finding of a moderate to abundant amount of regular granulosa cells, with or without nuclear longitudinal grooves, during cytologic examination of ovarian cysts considered benign by ultrasonography requires a careful search for microfollicular differentiation and Call-Exner bodies due to the rare but possible occurrence of cystic AGCT.
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ranking = 1
keywords = granulosa cell, granulosa
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5/13. Cystic adult granulosa cell tumor causing precocious pseudopuberty in a six-year-old girl.

    A very rare occurrence of adult granulosa cell tumor of the ovary (not of the juvenile type) causing precocious pseudopuberty in a six-year-old girl is described. An additional feature of interest was that the tumor appeared entirely cystic. To our knowledge, this condition in such a young premenarchal patient has not been reported previously.
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ranking = 0.71428571428571
keywords = granulosa cell, granulosa
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6/13. Unicystic granulosa cell tumor: a case report.

    Granulosa Cell Tumors (GCT) constitutes 1.5% to 3.5% of all primary ovarian neoplasms. They may be solid, cystic or both. Unilocular cystic GCT are very rare. We report here a case of 32 years female with unicystic GCT in which the distinction from follicular cyst was difficult and was made by carefully examining the lining of the cyst,which showed occasional multiple layers of granulosa cells with a few Call-Exner bodies.
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ranking = 0.71428571428571
keywords = granulosa cell, granulosa
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7/13. in vitro production of estradiol by ovarian granulosa cells in a case of McCune-Albright syndrome.

    A 14-year-old girl presented with classic McCune-Albright syndrome. She underwent the ablation of several cysts during a laparotomy performed on the basis of persistent and intense pelvic pain and recurrent episodes of menometrorrhagia not responsive to pharmacologic therapy. granulosa cells obtained from an isolated follicle and a cyst were cultured and estradiol (E2) secreted in the culture medium measured. granulosa cells, obtained from the follicle, produced much higher levels of estradiol compared to those of cells coming both from follicles of equivalent size and preovulatory follicles of normal patients. Secretion of E2 by granulosa cells from the cyst was comparable to that of normal preovulatory follicles. We conclude that in this patient, ovaries are hyperfunctioning in terms of E2 production. This high production of estradiol and the fact that several cysts were found in the ovaries can justify the high levels of estradiol found in the serum of this patient at the moment of the operation.
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ranking = 0.71428571428571
keywords = granulosa cell, granulosa
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8/13. Fine-needle aspiration cytology of ovarian follicle cysts with cellular atypia from reproductive-age patients.

    The cytologic features of four luteinized ovarian follicle cysts with cellular atypia, obtained by fine-needle aspiration, are presented and discussed. The three patients, ages 31, 32, and 34, underwent laparoscopy for workup of unilateral or bilateral ovarian cysts. In each case, the aspirates were cellular and composed of atypical cells arranged in glandular clusters and papillary configurations. The cells showed an increased nuclear/cytoplasmic ratio and contained nuclei with prominent chromocenters, granular chromatin, and prominent nucleoli, some irregular in shape. Cell borders were indistinct, and the cytoplasm was finely vacuolated. In each case, the smears were interpreted by the cytotechnologist as showing cellular features compatible with malignancy. In addition to the atypical cells, the cytopathologist noted a few sheets of well-preserved small granulosa cells. A thorough review of the clinical histories revealed the patients to be 8, 6, and 6 mo postpartum, respectively, at the time of needle aspiration. In conjunction with the clinical histories, the cytologic findings supported a diagnosis of follicle cysts containing atypical luteinized granulosa cells. It is postulated that hormonal stimulation may have played a role in the development of the cellular atypia present within the luteinized cells. When analyzing ovarian cyst fluid from reproductive-age patients, this entity should be considered so as not to make an erroneous diagnosis of malignancy.
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ranking = 0.28571428571429
keywords = granulosa cell, granulosa
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9/13. Hilus cell pathology and hirsutism.

    Hilus cell abnormalities are uncommon causes of hirsutism with virilization. Although hilus cell tumours have been well described, hilus cell hyperplasia is rare and is poorly defined clinically. We describe three cases of hilus cell hyperplasia and compare them with a case of hilus cell tumour. Both pathologies were associated with increased testosterone and oestradiol secretion. Suppression of testosterone to the 'normal range' in response to exogenous oestrogen was seen only in the cases with hyperplasia; only partial responsiveness was seen in the case with hilus cell tumour. Bilateral oophorectomy offers the potential for cure for both hilus cell hyperplasia and tumour.
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ranking = 0.0022056045024167
keywords = cell tumour
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10/13. Late-onset 3 beta-hydroxysteroid dehydrogenase deficiency with virilization induced by a large ovarian cyst.

    A midpubertal girl presented with secondary amenorrhea and a rapidly progressive deepening of her voice as the only signs of virilization. Diagnostic work-up yielded an extremely elevated plasma testosterone (289 ng/dl), low estradiol (29 pg/ml) levels and a large solitary cyst of the right ovary, which was totally removed. Pathohistology was in keeping with a granulosa cyst with mild luteinization. Normalization of testosterone (to 27.3 ng/dl) and estradiol (to 62 pg/ml) and resumption of regular menses after 2 months clearly indicated an autonomous function of the cyst. A malignant tumor was unequivocally excluded. Basal and ACTH stimulated levels of adrenal androgens pointed to a late-onset 3 beta-hydroxysteroid dehydrogenase deficiency, which per se is known to induce polycystic ovarian changes, but to date has never been described to be accompanied with a large and autonomous follicular cyst.
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ranking = 0.042166821337805
keywords = granulosa
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