Ovaries
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
- 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?s crystalloids, lipid, lipochrome pigment; resemble steroid cells by EM with microtubular smooth endoplasmic reticulum, mitochondria with tubular cristae
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
postmenopausal ovary usually has thick walled vessels, granulomas, hyaline scars
Ovarian lesions
developmental lesions
inflammatory lesions
tumoral 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
Videos
Histology of the ovary (by Washington Deceit)
See also
gonads