Adult Granulosa Cell Tumor : Differential

Comments:
Differential Diagnosis of Adult Granulosa Cell Tumor (GCT) of Ovary: continued from prev. image

Endometrial Stromal Sarcoma (ESS): Features favoring ESS include bilateral tumors, lack of endocrine manifestations, arteriolar vascular pattern, pericellular reticulin fiber network, and lack of staining with alpha-inhibin, FOXL2 and calretinin.

Undifferentiated Carcinoma: The diagnosis of undifferentiated carcinoma over adult GCT is favored by: nuclear hyperchromasia and pleomorphism, atypical mitoses, and absence of nuclear grooves. Adult GCT is positive for FOXL2, alpha-inhibin, calretinin, vimentin and negative for EMA. Adult GCT is confined to the ovary at presentation and has uniform nuclei with grooves.

The image shows ESS within vascular spaces.