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Hereditary Breast and Ovarian Cancer
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Granulosa cell tumor (GCT) includes small, bland, cuboidal to polygonal cells with a coffee bean−like longitudinal nuclear groove and a microfollicular structure (the Call-Exner body) and demonstrates microfollicular, macrofollicular, trabecular, insular, diffuse, and watered-silk (gyriform) growth patterns. Microfollicular GCT contains pathognomonic Call-Exner bodies (small rings of granulosa cells surrounding eosinophilic fluid and basement membrane material). Macrofollicular GCT contains one or more large cysts lined with granulosa cells. Trabecular and insular GCT have granulosa cells organized into nests and bands, with an intervening fibrothecomatous stroma present in trabecular GCT. Diffuse GCT contains sheets of cells arranged in no pattern. Watered-silk GCT contains cells arranged in single file in line. Adult GCT displays large, pale, ovoid or angular nuclei with nuclear grooves, mild nuclear atypia, few mitotic figures, little cytoplasm, and occasional luteinization. In contrast, juvenile GCT shows round hyperchromatic nuclei without nuclear grooves, severe nuclear atypia, more mitotic figures, and more cytoplasm (which is dense). GCT stains positive for inhibin alpha, vimentin, calretinin, CD99, smooth muscle actin, desmoplakin, S100 (50%), keratin (30%–50%), anti-Mullerian hormone (focally), desmin (35%), and silver stains (reticulin surrounding cluster of cells), but negative for EMA. Molecularly, GCT shows monosomy 22 (∼40%), trisomy 12 (∼30%), +14 (∼30%), monosomy X (∼10%), monosomy 17 (5%), although most tumors (80%) are diploid or near-diploid.
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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Call-Exner Bodies Minute degenerative cysts in ovarian granulosa cells. Described by Emma Call and Siegmund Exner (1846–1926) of Vienna in 1875. Some historians have mistakenly credited Friedrich von Call (1844–1917), a physician in Vienna, with this discovery.
Ovarian Cancer
Published in Dongyou Liu, Tumors and Cancers, 2017
Granulosa cell tumor (GCT) of the pure sex cord tumor category typically presents as unilateral, gray or yellow, solid to cystic masses (average 12 cm) with a smooth lobulated surface. Histologically, GCT includes small, bland, cuboidal to polygonal cells with a coffee bean–like longitudinal nuclear groove and a microfollicular structure (the Call–Exner body). GCT demonstrates microfollicular, macrofollicular, trabecular, insular, diffuse, and watered-silk (gyriform) growth patterns. Microfollicular GCT contains pathognomonic Call–Exner bodies (small rings of granulosa cells surrounding eosinophilic fluid and basement membrane material). Macrofollicular GCT contains one or more large cysts lined with granulosa cells. Trabecular and insular GCT have granulosa cells organized into nests and bands, with an intervening fibrothecomatous stroma present in trabecular GCT. Diffuse GCT contains sheets of cells arranged in no pattern. Watered-silk GCT contains cells arranged in single file in line. Adult GCT displays large, pale, ovoid or angular nuclei with nuclear grooves; mild nuclear atypia; few mitotic figures; little cytoplasm; and occasional luteinization. In contrast, juvenile GCT shows round hyperchromatic nuclei without nuclear grooves, severe nuclear atypia, more mitotic figures, and more cytoplasm (which is dense). GCT stains positive for inhibin-α, vimentin, calretinin, CD99, smooth muscle actin, desmoplakin, S100 (50%), keratin (30%–50%), anti-Müllerian hormone (focally), desmin (35%), and silver stains (reticulin surrounding cluster of cells), but negative for EMA. Molecularly, GCT shows monosomy 22 (~40%), trisomy 12 (~30%), trisomy 14 (~30%), monosomy X (~10%), and monosomy 17 (5%), although most tumors (80%) are diploid or near diploid [6].
Androgen-secreting adult granulosa cell tumor in a woman with polycystic ovary syndrome: a case report
Published in Gynecological Endocrinology, 2022
Chongjuan Gu, Xiaoqin Zeng, Quan Shi, Qing Xiao, Yaojuan He
The patient underwent laparoscopic left ovarian cystectomy and the mass did not rupture during the procedure. Intraoperative rapid frozen section pathological detection of ovarian tumors indicated that granulosa cell tumors could be a possibility, then a left salpingo-oophorectomy was performed, followed by meticulously inspecting the right ovary and fallopian in normal morphology. Considering the tumor is of low potential malignancy, and it is necessary to preserve reproductive function for patient, postoperative radiotherapy and chemotherapy were not performed. Microscopic examination of the left ovarian mass revealed diffuse, solid, cordlike, trabecular and pseudopapillary structures as well as part luteinization (Figures 2A and 2B). We also observed minor cell luteinization and Call-Exner bodies. The tumor cells had fine chromatin and round-to-oval nuclei with a single small nucleolus. Some nuclei, known as ‘coffee-bean’ nuclei, showed pale, round longitudinal grooves (Figure 2C). Tumors stained positive for inhibin-a, ER and PR (Figures 2D, 2E and 2F). Therefore, combine clinical symptoms and hyperandrogenism, the findings supported the final diagnosis of androgen -secreting AGCT (moderately differentiated trabecular type) in the left ovary.