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Vascular embolization of benign granulosa cells
A E Smith1, J P Harmon, F A Deogracias
1Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
Objective(S):
Most conditions involving sex cord-stromal cells can be diagnosed on morphologic criteria alone. We describe a case of vascular embolization of benign granulosa cells in which immunohistochemistry was of value as a diagnostic tool.
Methods:
We reviewed the clinical history and gross pathologic findings from a 48-year-old patient who presented with abdominal pain and fullness. Formalin-fixed paraffin-embedded sections were examined by routine H&E and immunohistochemical stains.
Results:
Histologic examination of a grossly enlarged and cystic ovary revealed nests of cells within angiolymphatic spaces. Although the cells were cohesive and atypical, they were morphologically similar to the nearby graafian follicle. Immunohistochemistry showed positive labeling with antibodies to inhibin-alpha and cytokeratin in a pattern consistent with benign granulosa cells.
Conclusion(S):
Immunohistochemical stains for inhibin-alpha and cytokeratin are useful tools to help confirm granulosa cell origin, as demonstrated in this case involving an atypical histomorphologic picture of "embolization."