ovary

Anatomy

 The ovaries are close to the lateral pelvic wall, behind the broad ligament, anterior to the Rectum

- The ovaries are connected to the broad ligament by the mesovarium (double fold of the peritoneum), to the uterine cornu by the utero-ovarian ligament, to the lateral pelvic side wall by the infundibulopelvic ligament (suspensory ligament).

 Premenopausal ovaries are each 4 cm long and weight 5-8 g.

 Lymphatic vessels are drained to para-aortic, internal iliac, external iliac, common iliac, sacral, obturator, pelvis, retroperitoneal, inguinal nodes.

Components

 ovarian surface epithelium
 ovarian stroma
 ovarian vessels (ovarian blood vessels, ovarian lymphatics )
 ovarian follicles

• primordial follicles
• maturing follicles
  • preantrak folliles
  • antral follicle
  • graafian follicle

 corpus luteum
 corpus albicans
 ovarian hilus / ovarian hilus cells
 rete ovarii

Normal histology

 The ovaries are covered by the ovarian surface epithelium (modified mesothelium, also called coelomic or germinal epithelium), closely related to mullerian duct lining epithelium.

 The ovarian stroma contains fibroblastic cells orghanized in whorls or have a storiform pattern, and surrounded by dense reticulin network. The ovarian stroma contains luteinized stromal cells, decidual cells, smooth muscle cells, adipocytes (fat), neuroendocrine cells and endometrial stroma-like cells.

 ovarian follicles

• primordial follicles
  • 400,000 primordial follicles containing primary oocytes are present at birth in ovarian stroma.
  • The primordial follicles travels from yolk sac endoderm to ovary, develops into oogonia and oocytes, arrests at prophase of mitosis

• maturing follicles (primary follicles, secondary follicles, tertiary follicles, graafian follicles)
  • A maturing follicle is an oocyte with granulosa layer. It lacks reticulum and are immunoreactive for vimentin, keratin, desmoplakin.
  • They contains Call-Exner bodies and theca cells.

• Prominent cystic follicles are present at birth and puberty.

• atretic follicles

 corpora lutea (corpus luteum)
 corpora albicantia

 ovarian hilus cells

• in ovarian medulla, round to polygonal, epithelial appearing, around vessels, presumed vestigial remnant of gonad from its "ambisexual" phase; produce steroids; resemble Leydig cells of testis; may produce masculinizing tumors (hilar cell tumors); closely associated with large hilar veins and lymphatics and may protrude within their lumina; also associated with nerves; may contain Reinke’s crystalloids, lipid, lipochrome pigment; resemble steroid cells by EM with microtubular smooth endoplasmic reticulum, mitochondria with tubular cristae

 rete ovarii

 Walthard cell nests

 ovarian hilar mesonephric rests

• association with nonteratoid prostatic differentiation

 ovarian hilar cell hyperplasia (associated with hCG administration, pregnancy, choriocarcinoma)

Immunochemistry

 calretinin (granulosa and theca cells)
 smooth muscle actin (SMA) (stroma cells)
 desmin (stroma cells)

Variants

 neonatal ovary
 infancy ovary
 child ovary
 pubertal ovary
 young adult ovary
 adult ovary
 premenopausal ovary
 post-menopausal ovary usually has thick walled vessels, granulomas, hyaline scars

Pathology

 ovarian anomalies
 ovarian lesions

• developmental lesions
• inflammatory lesions

 ovarian diseases

• anomalies of development
• dysimmunitary diseases
  • autoimmune oophoritis

• ovarian infections
• ovarian vascular diseases
• ovaries in metabolic diseases
• ovarian changes secondary to cytotoxic drugs and radiation
• ovarian tumors (ovarian tumoral lesions)

Videos

 Histology of the ovary (by Washington Deceit)

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See also

 gonads

• Testis