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ovary

Sunday 18 February 2007

Anatomy

- The ovaries are close to the lateral pelvic wall, behind the broad ligament, anterior to the Rectum

- The ovaries are connected to the broad ligament by the mesovarium (double fold of the peritoneum), to the uterine cornu by the utero-ovarian ligament, to the lateral pelvic side wall by the infundibulopelvic ligament (suspensory ligament).

- Premenopausal ovaries are each 4 cm long and weight 5-8 g.

- Lymphatic vessels are drained to para-aortic, internal iliac, external iliac, common iliac, sacral, obturator, pelvis, retroperitoneal, inguinal nodes.

Components

- ovarian surface epithelium
- ovarian stroma
- ovarian vessels (ovarian blood vessels, ovarian lymphatics)
- ovarian follicles

  • primordial follicles
  • maturing follicles
    • preantrak folliles
    • antral follicle
    • graafian follicle
    • atretic follicles

- corpus luteum
- corpus albicans
- ovarian hilus cells
- rete ovarii

Normal histology

- The ovaries are covered by the ovarian surface epithelium (modified mesothelium, also called coelomic or germinal epithelium), closely related to mullerian duct lining epithelium.

- The ovarian stroma contains fibroblastic cells orghanized in whorls or have a storiform pattern, and surrounded by dense reticulin network. The ovarian stroma contains luteinized stromal cells, decidual cells, smooth muscle cells, adipocytes (fat), neuroendocrine cells and endometrial stroma-like cells.

- ovarian follicles

  • primordial follicles
    • 400,000 primordial follicles containing primary oocytes are present at birth in ovarian stroma.
    • The primordial follicles travels from yolk sac endoderm to ovary, develops into oogonia and oocytes, arrests at prophase of mitosis
  • maturing follicles (primary follicles, secondary follicles, tertiary follicles, graafian follicles)
    • A maturing follicle is an oocyte with granulosa layer. It lacks reticulum and are immunoreactive for vimentin, keratin, desmoplakin.
    • They contains Call-Exner bodies and theca cells.
  • Prominent cystic follicles are present at birth and puberty.
  • atretic follicles

- corpora lutea (corpus luteum)
- corpora albicantia

- ovarian hilus cells

  • in ovarian medulla, round to polygonal, epithelial appearing, around vessels, presumed vestigial remnant of gonad from its "ambisexual" phase; produce steroids; resemble Leydig cells of testis; may produce masculinizing tumors (hilar cell tumors); closely associated with large hilar veins and lymphatics and may protrude within their lumina; also associated with nerves; may contain Reinke‚Äôs crystalloids, lipid, lipochrome pigment; resemble steroid cells by EM with microtubular smooth endoplasmic reticulum, mitochondria with tubular cristae

- rete ovarii

- Walthard cell nests

- ovarian hilar mesonephric rests

  • association with nonteratoid prostatic differentiation

- ovarian hilar cell hyperplasia (associated with hCG administration, pregnancy, choriocarcinoma)

Immunochemistry

- calretinin (granulosa and theca cells)
- smooth muscle actin (SMA) (stroma cells)
- desmin (stroma cells)

Variants

- neonatal ovary
- infancy ovary
- child ovary
- pubertal ovary
- young adult ovary
- adult ovary
- premenopausal ovary
- post-menopausal ovary usually has thick walled vessels, granulomas, hyaline scars

Pathology

- ovarian anomalies
- ovarian lesions

  • developmental lesions
  • inflammatory lesions

- ovarian diseases

  • anomalies of development
  • dysimmunitary diseases
    • autoimmune oophoritis
  • ovarian infections
  • ovarian vascular diseases
  • ovaries in metabolic diseases
  • ovarian changes secondary to cytotoxic drugs and radiation
  • ovarian tumors (ovarian tumoral lesions)

Videos

- Histology of the ovary (by Washington Deceit)

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See also

- gonads

  • Testis

Portfolio

  • Menopausal ovary
  • Normal ovary (21 years)
  • Normal ovary (21 years)
  • Ovaire (1 an)
  • Fetal ovaries (21 weeks)