Cystic Adult Ovarian Granulosa Cell Tumor as a Potential Source of False Negative Diagnosis in Ovarian Cytology

Cytologic Features of Granulosa Cell Tumors in Fluids and Fine Needle Aspiration Specimens

“…Potential pitfalls include a predominantly cystic GCT that may be misinterpreted as a follicular cyst. 20,21 …”

Cystic Fluid and Fine Needle Aspiration Cytopathology of Cystic Adult Granulosa Cell Tumor of the Ovary

“…Among these, AGCT is found in rare cases and may be diagnosed as a functional cyst on both ultrasonography and cytopathology. 5 The gross appearance of AGCT ranges from totally solid to almost totally cystic. AGCTs composed of only one or several thin-walled cysts are extremely rare and account for only 3% of AGCTs.…”

“…2,3,6 They can be erroneously diagnosed as follicular cysts by sonography and FNA and therefore may be a source of false negative results. 5 A predominantly cystic GCT that may be misinterpreted as a follicular cyst is a potential pitfall when examining ovarian cyst fluid. 7 On cytopathology, they contain small clusters of cells in a rosette pattern with a central hyaline globule, which is green-blue on Papanicolaou stain and magentapink on Romanowsky stain.…”

“…2,7 The finding of a moderate to abundant amount of regular granulosa cells, with or without nuclear longitudinal grooves, during cytopathologic examination of ovarian cysts considered benign by ultrasonography requires a careful search for microfollicular differentiation and Call-Exner bodies due to rare but possible occurence of cystic AGCT. 5 Tumor cells are arranged around small cavities containing pinkish material mimicking Call-Exner bodies of the developing graffian follicles. 2 Other reported cytopathologic features are loose monolayers, individual cells, vacuolated cytoplasm, a second population of elongated theca cells and exuberant capillaries associated with papillary-like fronds.…”

Fine needle aspiration cytology of cystic primary adult granulosa cell tumor of the ovary: Potential diagnostic pitfalls with other cystic ovarian lesions

“…This may be due to low cellularity of the sample and secondary degenerative changes. 5 The main differential diagnosis of cystic granulosa cells tumor is functional cyst. It is important to distinguish them because functional cysts may be treated conservatively while granulosa cell tumor or epithelial lined cysts should probably be removed because of their neoplastic potential.…”