This document summarizes diseases of the ovaries, classifying them into primary inflammatory disorders, functional cysts, and ovarian tumors. It describes the histological structure of the normal ovary and then discusses each disease type in detail, including their morphology, pathogenesis, and potential complications. Primary inflammatory disorders cause premature ovarian failure through autoimmune destruction. Functional cysts include follicular, luteal, and stromal hyperthecosis cysts. Ovarian tumors are further divided into surface epithelial-stromal tumors, sex cord-stromal tumors, germ cell tumors, and metastatic cancers from other primary sites. Each tumor type has specific subtypes and histological features.

1. DISEASES OF
THE OVARIES
NAME: HERMAN NDJAMEN
GROUP: 305

2. PLAN
• Histological structure of normal ovary
• Classification of Ovarian Diseases
• Features of Each Diseases
• Possible Complications

3. The ovary has three main histologic compartments:
(1) the surface müllerian epithelium
(2) the germ cells
(3) the sex cord–stromal cells.

4. CLASSIFICATION OF OVARIAN
DISEASES
OVARIAN
DISEASES
PRIMARY
INFLAMMATORY
DISORDER
Tumors
Functional
cysts

5. I- PRIMARY INFLAMMATORY DISORDER
(Autoimmune Oophoritis)
Definition: Autoimmune oophoritis is an
autoimmune inflammation of ovaries resulting in
their destruction, atrophy, and fibrosis.
It is a rare disease that causes premature ovarian
failure (POF) in 10 percent of cases characterized by
premature menopause before 40 years of age.
Pathogenesis: Autoimmune oophoritis is caused by
presence of special autoantibodies (StCA) that react
both against steroid-producing cells in adrenal
glands and gonad as well.

8. OTHER FORMS AND COMPLICATIONS
OTHER FORMS:
• XANTHOGRANULOMATOUS OOPHORITIS
• PARASITIC OOPHORITIS
• BILATERAL CYTOMEGGALOVIRUS OOPHORITIS
COMPLICATIONS:
* PRIMARY AMENORRHEA (MENSTRUATION HAS NEVER
OCCURRED),
* SECONDARY AMENORRHEA (MENSTRUATION APPEARED
AT PUBERTY BUT SUBSEQUENTLY STOPPED),
* INFERTILITY
* PRIMARY OVARIAN FAILURE

9. II- FUNCTIONAL CYSTS
A- FOLLICULAR CYSTS
Cystic follicles in the ovary are so common that they are
considered virtually normal. They originate in unruptured graafian
follicles or in follicles that have ruptured and immediately sealed.
Morphology:
These cysts are usually multiple. They range in size up to 2 cm in
diameter, are filled with a clear serous fluid, and are lined by a gray,
glistening membrane.
Granulosa lining cells can be identified histologically if the
intraluminal pressure has not been too great. The outer theca cells
may be conspicuous due to increased amounts of pale cytoplasm
(luteinized).
It may be associated with increased estrogen production and
endometrial abnormalities.

11. B- LUTEAL CYSTS.
These are cysts from which the granulosa cells have disappeared leaving a cyst
surrounded by luteinized tissue.
MORPHOLOGY: The cysts are typically 2-3 cm in diameter lined by a rim of bright yellow
tissue containing luteinized granulosa cells.
There is continued production of progesterone that leads to menstrual impairment .
COMPLICATION: Rupture of the cyst may lead to peritoneal reaction

12. C- STROMAL HYPERTHECOSIS
Also called cortical stromal hyperplasia, it is a disorder of ovarian stroma most
commonly seen in postmenopausal women.
MACROSCOPICALLY:
The disorder is characterized by uniform enlargement of the ovary (up to 7 cm),
which has a white to tan appearance on sectioning.
MICROSCOPICALLY:
There is hypercellular stroma and luteinization of the stromal cells, which are visible
as discrete nests of cells with vacuolated cytoplasm.

13. D- Polycystic ovarian disease (PCOD, SteinLeventhal
syndrome)
Affecting 3% to 6% of reproductive-age women, the central pathologic
abnormality is numerous cystic follicles, often associated with oligomenorrhea.
Women with PCOD have persistent anovulation, obesity (40%), hirsutism
(50%), and, rarely, virilism.
PATHOGENESIS:
The initiating event in PCOD is not clear, but It is now believed that a
variety of enzymes involved in androgen biosynthesis are poorly regulated in
PCOD.
MORPHOLOGY:
Macroscopically, the ovaries are usually twice normal size and have a
smooth, gray-white outer cortex studded with subcortical cysts 0.5 to 1.5 cm in
diameter.
Microscopically, there is a thickened, fibrotic superficial cortex beneath
which are innumerable follicle cysts associated with hyperplasia of the theca
interna

15. III- OVARIAN TUMOURS.
SURFACE
EPITHELIAL-
STROMAL TUMORS
SEX CORD–
STROMAL TUMORS
GERM CELL TUMORS
METASTATIC
CANCER FROM
NONOVARIAN
PRIMARY
Serous tumors
Granulosa tumors Teratoma Colonic, appendiceal
Mucinous tumors Fibromas Dysgerminoma Gastric
Endometroid tumors Fibrothecomas
Yolk sac tumor
(endodermal sinus
tumor)
Breast
Clear cell tumors Thecomas
Mixed germ cell
tumors
Transitional cell
tumors
Sex cord tumor with
annular tubules
Epithelial-stromal Gynandroblastoma
Steroid (lipid) cell
tumors

16. SEROUS TUMORS
These common cystic neoplasms are lined by tall, columnar, ciliated and
nonciliated epithelial cells and are filled with clear serous fluid. They may be
Benign, Borderline and malignant. Some examples of serous tumors are:
CYSTADENOMAS: Benign tumours which may include cystic areas
CYSTADENOFIBROMAS: containing cystic and fibrous areas
ADENOFIBROMAS: containing predominantly fibrous areas
CYSTADENOCARCINOMA: Malignant tumour containing cystic component
MUCINOUS TUMOURS
These types of tumours include:
- Benign and borderline Cystadenomas
- Primary mucinous Carcinomas

17. SEX CORD–STROMAL TUMORS
GRANULOSA–THECA CELL TUMORS:
Ovarian neoplasms composed of varying proportions of granulosa
and theca cell differentiation.
FIBROMAS: Tumors arising in the ovarian stroma that are
composed of fibroblasts
THECOMAS: Composed of plump spindle cells with lipid droplets.
FIBROTHECOMAS: Tumors containing a mixture of these cells

18. GERM CELL TUMORS

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ATTENTION