PMC6350347_01
Macroscopic aspects of the ovarian tumors. a (right ovary): a well circumscribed solido-cystic tumor, the cut surface showed a vaguely lobulated whitish tumor with cystic areas filled of pasty yellowish material. b (left ovary): a whitish lobulated tumor with a cystic areas containing a chocolate-like hemorrhagic material
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Fig1
Histologic aspects of the ovarian tumors. a (right ovary): the histological image showing ovarian parenchyma infiltrated by a diffuse tumoral proliferation. A focus of endometriosis is shown (Hematoxylin and eosin stain x 100). b: the tumor cells are round to spindle with oval hyperchromatic nuclei and moderate cytological atypia. The tumor stroma showed numerous juxtaposed small arterioles with sometimes hyalinazed walls. Tumor cells surrounded these vessels in a striking whorling pattern (Hematoxylin and eosin stain x 200)
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Fig2
Tumor cells surrounded these vessels in a striking whorling pattern (Fig. 2a and b).
a (Endometriosis): a focus of regular dilated endometrioid glands embedded in the tumor (Hematoxylin and eosin stain x 200). b: At the peripheral ovarian parenchyma, a tongue-like protrusion in the vessel walls is seen (Hematoxylin and eosin stain x 100)
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Fig3
The histological examination of the right adnexal lesion showed ovarian parenchyma largely occupied by a diffuse tumoral proliferation composed of round to spindle cells with oval hyperchromatic nuclei and moderate cytological atypia, the mitotic figures were scant (3 mitoses/10 high-power fields). In some areas of the tumor (especially cystic areas), foci of regular dilated endometrioid glands were found intimately embedded in the tumor (Fig. 3a). At the periphery of the ovarian parenchyma, a tongue-like protrusion in the vessel walls was observed (Fig. 3b).
Immunohistochemical features of the tumor (x 200). a: tumor cells are positive for CD 10. b: tumor cells stain positive for progesterone receptors
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Fig4
The histological examination of the right adnexal lesion showed ovarian parenchyma largely occupied by a diffuse tumoral proliferation composed of round to spindle cells with oval hyperchromatic nuclei and moderate cytological atypia, the mitotic figures were scant (3 mitoses/10 high-power fields). At immunohistochemistry, tumor cells were positive for CD 10 and for estrogen and progesterone receptors (ER, PR) (Fig. 4a and b), with focal positive staining with desmin.
Immunostaining for smooth muscle actin (SMA) is negative in tumor cells, but highlights the tumor stromal rich-vasculature with hyalinazed vessels (x 200)
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Fig5
The histological examination of the right adnexal lesion showed ovarian parenchyma largely occupied by a diffuse tumoral proliferation composed of round to spindle cells with oval hyperchromatic nuclei and moderate cytological atypia, the mitotic figures were scant (3 mitoses/10 high-power fields). They were negative for smooth muscle actin (SMA) (Fig. 5), inhibin, calretinin and synaptophysin.