A study of the reticulum and of luteinization in granulosa and theca cell tumors of the ovary

Abstract

1.1. In the Graafian follicle and corpus luteum, as well as in tumors containing theca and granulosa cells, the relationship of the reticulum furnishes a means of identifying the two types of cells. The theca cells are always individually surrounded by this connective tissue element, whereas granulosa cells and lutein cells are enclosed not at all, or as groups of cells.2.2. Granulosa and theca cell tumors are not only closely related, but in all probability, most human granulosa cell tumors contain varying proportions of both types of cells.3.3. These tumors undergo luteinization in the same manner as does the Graafian follicle. The cause of luteinization is not known, excepting that it is found in the older tumors of the mouse's ovary and may be therefore an expression of age or maturity.4.4. The phospholipid content of the tumors is low per unit of weight, as compared with that of the corpus luteum. This may, in part, be due to the greater connective tissue content and areas of degeneration.5.5. The life cycle of the granulosa cells, together with the fact that the tumor composed of them contains foci which differ widely in degrees of maturity, explains some of the clinical phenomena observed in patients harboring this type of growth.6.6. Luteinization of granulosa cell tumors in small or moderate degree is common. Seventeen instances reported in the literature have been found where the major portion of the tumor had undergone lipoid change. Complete luteinization is rare and is usually found in small tumors.7.7. If allowed to mature, one of three different terminations is thought to be the end of the life cycle of granulosa cell tumors: (a) luteinization followed by lipoid degeneration; (b) ischemic necrosis; and (c) collagenous degeneration followed by fibrosis. In tumors composed chiefly of theca elements, collagenous degeneration and fibrosis are the usual sequelae to the luteinization phase.