12
Peritoneal Washings and Ovary
Fig. 12.10 Mature cystic teratoma. Oophorectomy specimen shows a
large tumor with visible hair strands.
Fig. 12.11 Mature cystic teratoma. Skin and adnexal structures are
identified (H&E x LP).
Fig. 12.12 Mature cystic teratoma. Squamous cells, hair and debris
(Papanicolaou x MP).
fluid from malignant neoplasms may harbor few or no malig-
nant cells and contain only inflammatory and necrotic debris.
Key features of benign mucinous tumors
• Low to moderate cellularity, often degenerated;
• Numerous foamy macrophages;
• Mucin-producing, endocervical-type columnar cells;
• Round to oval nuclei and/or goblet cells; and
• Mucinous background.
Mature Cystic Teratoma
The most common
germ cell tumor
is the
mature cystic teratoma,
a benign neoplasm derived from the ovum that differentiates
into mature ectoderm, mesoderm, and/or endoderm. Skin and
adnexal structures are identified commonly; thus the appellation
"dermoid cyst" has been applied (Figs 12.10, 12.11). Aspiration
usually yields a fairly cellular specimen composed of squamous
cells, keratinaceous material, and amorphous clumps of cellular
debris (corresponding to the grumous material seen grossly).
Strands of hair are occasionally seen. Other cellular elements
that may be present include sebaceous cells, mesenchymal cells
(e.g., adipocytes), and glandular and columnar epithelial cells
(Fig. 12.12).60
Key features of mature cystic teratoma
• Cellular aspirate;
• Most commonly, squamous cells, keratinous and
amorphous debris;
• Other differentiated cell types, e.g., sebaceous cells, fat
cells, enteric or respiratory epithelium, possibly seen;
and
• Hair strands.
Immature Teratoma
Immature teratomas
may show focal cystic areas. These tumors
contain differentiated as well as immature cellular elements.
Neuroblastic tissue is one of the more common immature
elements that may be encountered.
Key features of immature teratoma
• Immature cells, usually neuroblastic tissue, are key;
• Small cells with high N/C ratio and primitive chroma-
tin are present; and
• Differentiated elements may also be present as in
mature teratomas.
Dysgerminoma
Dysgerminomas
only rarely have cystic foci.63 Tumor cells charac-
teristically have large anisokaryotic nuclei, prominent nucleoli,
and foamy cytoplasm. Lymphocytes may also be present. The
cytologic appearance of dysgerminoma is entirely similar to that
noted for seminoma in males (see Chapter 26).
Key features of dysgerminoma
• Large cells with variably-sized nuclei;
• Prominent nucleoli and foamy cytoplasm; and
• Small lymphocytes in the background.
Granulosa Cell Tumors
Sex cord-stromal tumors
are usually solid neoplasms, with the
exception of
granulosa cell tumors
(GCT), which are generally
solid and cystic. The most common is the adult form, composed
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