Adult granulosa cell tumor of the ovary: Fine‐needle‐aspiration cytology of 10 cases and review of literature

Abstract

Adult granulosa cell tumor (GCT) of the ovary is mostly diagnosed in postmenopausal women. They typically secrete estrogen, which stimulates the endometrium to proliferate and cause abnormal bleeding. This study reviews the cytologic features of adult GCT of the ovary diagnosed by fine-needle aspiration (FNA). We reviewed slides from ten cases diagnosed by CT guided FNA from 1995 to 2007 at our institutions. Smears were stained with Diff-Quik and Papanicolaou stains. Patient's history and histologic diagnosis were also available and reviewed for all cases. The patients ranged in age from 39 to 83 yr. All 10 cases were hypercellular with both large and small overlapping cell clusters and individual cells. The cytologic features identified included: naked nuclei (10/10 cases), Call-Exner bodies (7/10 cases), blood vessels with prominent perivascular tumor cell growth (4/10 cases), spindle-shaped hyperchromatic stromal cells within cellular clusters (6/10 cases), mixed inflammation (3/10 cases), tumor cell necrosis (1/10 cases), and prominent metachromatic stroma seen in association with blood vessels (1/10 cases). Moderate to scant delicate cytoplasm was also seen (10/10 cases). Small, punctuate cytoplasmic vacuoles were also noted (7/10 cases) and were occasionally prominent (3/10 cases). In general nuclear to cytoplasmic ratios were high although lower than those typically seen in a lymphoma or small-cell carcinoma. Nuclei were generally centrally located although eccentrically located nuclei were consistently seen in a minority of cells. Nuclei were monotonous in size showing slightly convoluted (occasional rentiform and fetiform nuclei) to polygonal outlines. Prominent, central nucleoli were also seen (4/10 cases). Nuclear grooves were also seen (9/10 cases). No atypical mitotic activity was identified in any of the 10 cases (0/10 cases). In summary, the above cytologic features can also help in the cytologic diagnosis of adult GCTs.

Fine-Needle Aspiration Biopsies of Ovarian Masses: A Reliable Technique

“…The cytological findings in our granulosa cell tumors shared many similarities with a study by Ali et al [11], who also mentioned some more details about spindle-shaped hyperchromatic stroma cells within cellular clusters. In 2 cases of thecofibroma and leiomyoma, the smears were hypocellular, containing rare tissue fragments and bland-looking spindle cells.…”

Granulosa Cell Tumor of the Ovary

“…[2][3][4][5] While the histologic features of adult and juvenile GCT are clearly established, only a few papers describe their cytologic features, and most are brief reports. [8][9][10][11][12][13][14][15][16][17][18][19] We herein describe the cytologic features of 7 ovarian GCTs (6 AGCTs and 1 JGCT) and compare our results with those of others cited in the literature.…”

“…These cytologic features were selected because of their previous (and repeated) description in the cytology literature. [8][9][10][11][12][13][14][15][16][17][18][19] In addition, each case was examined for single cell necrosis, increased mitoses (normal and abnormal) and features of cellular atypia. For the purpose of the study, cellular atypia was defined as tumor cells showing; pleomorphism, hyperchromasia, prominent nucleoli (2-3 μm or larger) and/or increased mitoses.…”

Delayed Menopause Due to Ovarian Granulosa Cell Tumour

“…Low staging at diagnosis confers an excellent prognosis with a 5 year survival rate of 75-95% (Stage 1) and survival rate drops down with advanced stage [10]. Though the prognosis of granulosa cell tumours is good, patients have to be on long term follow up to detect late recurrence.…”