Anechoic areas in the ovary

Some women choose to have a physical examination for the sake of their own health. When doing B-ultrasound, you may encounter what the doctor calls echo-free areas in the ovaries. Many women may not understand what this means. In fact, to put it simply, this may be a disease called corpus luteum cyst. Corpus luteum cyst disease usually occurs in married women of childbearing age, who may experience symptoms of lower abdominal pain.

1. Lutein cyst

The corpus luteum is more active due to the imbalance of pituitary gonadotropin, especially in pregnancy, so the cavity is larger and contains more fluid. If the diameter of the cavity increases to more than 2 cm, it is a corpus luteum cyst.

2. Albumin cyst

It is mostly caused by corpus luteum cysts and the evolution of cystic corpus luteum. It is also possible that a cyst is formed due to certain factors when the normal corpus luteum degenerates into the corpus albicans.

3. Theca lutein cyst

It often occurs in hydatidiform mole, invasive hydatidiform mole, and choriocarcinoma. It occasionally occurs in normal pregnancies and twin pregnancies.

Clinical manifestations

It can occur in married or unmarried women, most commonly in women of childbearing age, and is often discovered during B-ultrasound examinations. Corpus luteum rupture usually occurs on the 20th to 27th day of the menstrual cycle, with sudden lower abdominal pain, nausea, vomiting, and frequent urination and defecation. In severe cases, symptoms of shock such as dry mouth, palpitations, dizziness, blurred vision and so on may occur. Physical signs include anemia, rapid pulse rate, and decreased blood pressure. There is rebound tenderness and positive shifting dullness in the lower abdomen. The cervix is ​​tender when raised, and the posterior fornix is ​​full and tender. An ill-defined mass with obvious tenderness can be felt on one side of the uterus.

examine

1. Visual inspection

Most of them are unilateral, with a diameter generally not exceeding 4 cm, and occasionally up to 10 cm. In the early stage, it may resemble hematoma, but after the blood is absorbed, it will contain transparent or brown serous fluid. The cyst wall is light yellow.

2. Light microscopy

In the early stage of cyst formation, luteal cells are still present and rich in lipids. Only the inner layer of the cyst wall is fibrotic, with luteinized granulosa cells and theca cells visible, and there may or may not be blood in the cyst. In the later stage, the cyst wall is fibrotic with varying degrees of hyaline changes.

diagnosis

B-ultrasound examination is simple, easy, intuitive and accurate, and is painless and harmless to patients, making patients happy to accept it. When an ovarian tumor cannot be excluded, laparoscopy or laparotomy can be performed if necessary to make a definitive diagnosis.