Ovary - nontumor
Nonneoplastic cysts / other
Follicular cysts

Author: Mohiedean Ghofrani, M.D. (see Authors page)

Revised: 19 September 2017, last major update August 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Ovarian follicular cysts [title]

Cite this page: Ghofrani, M. Follicular cysts. PathologyOutlines.com website. http://pathologyoutlines.com/topic/ovarynontumorfollicularcysts.html. Accessed September 24th, 2017.
Definition / general
  • Benign, ovarian cyst measuring at least 3 cm and lined by granulosa and theca interna cells
Terminology
  • If < 3 cm, termed a cystic follicle; if > 3 cm, termed a follicular cyst
Epidemiology
  • Follicular cyst is common in reproductive years
Etiology
  • Ovarian follicle matures during proliferative phase of menstrual cycle, then LH surge causes release of mature oocyte at midcycle, then follicle transforms to a corpus luteum
  • If no fertilization, corpus luteum typically atrophies, eventually forming a corpus albicans
  • If no LH surge or no ovulation, follicle grows and becomes a cyst, which usually disappears within 2 - 3 menstrual cycles but may persist
Clinical features
  • Usually asymptomatic or forms an adnexal mass
  • Pedicle may twist and cause hemorrhagic infarction
  • Associated with precocious puberty in children
  • May be multiple when a component of McCune-Albright syndrome (polyostotic fibrous dysplasia, cutaneous melanin pigmentation and endocrine organ hyperactivity)
Case reports
Treatment
Gross description
  • Rarely greater than 8 cm
  • Glistening membrane
  • Thin walled
  • Unilocular or multilocular
  • Clear or serous fluid contents
  • No solid component
Gross images

Images hosted on PathOut server:

A unilocular cyst has a smooth lining



Images hosted on other servers:

Follicular cyst

Large follicular cysts

Follicular cysts and corpus luteum

Microscopic (histologic) description
  • Outer layer of theca interna cells, usually luteinized and may be surrounded by reticulum
  • Variable inner layer of granulosa cells, luteinized after puberty
Microscopic (histologic) images

Images hosted on PathOut server:

Cyst is lined by luteinized granulosa cells overlying luteinized theca cells (AFIP)



Images hosted on other servers:

Epithelial lining

Theca lutein cyst

Inhibin stain

Cytology description