GYNECOLOGIC

ONCOLOGY

6, 391-394 (1978)

CASE REPORT Paneth

BRADLEY

Cells in a Mutinous Cystadenoma the Ovary: Light and Electron Microscopic Study BIGELOW,

*Associate Pathology,

M.D.,*,’

of

AND ANCEL BLAUSTEIN, M.D.t

Professor of Pathology and Winical Professor of New York University Medical Center, 550 First Avenue, New York, New York 10016

Received October 24, 1977 The light and electron microscopic features of an ovarian mutinous cystadenoma with prominent Paneth cells are described.

INTRODUCTION

Benign mutinous cystic tumors of the ovary are lined by epithelium of both endocervical and intestinal types [I]. Masson [6] and Scully [8] have both described finding Paneth cells in mutinous ovarian tumors. A case is presented in which the Paneth cells were studied by both histochemistry and transmission electron microscopy. MATERIALS

AND METHODS

A 63-year-old woman with an incidentally discovered adnexal mass had a 20-cm multiloculated mutinous cystadenoma of the left ovary removed at total abdominal hysterectomy, bilateral salpingo-oophorectomy. The tissue was fixed in 10% buffered formalin. Sections for light microscopy were stained with hematoxylin and eosin, Mayer’s mucicarmine, alcian blue, periodic acid-Schiff, and Lendrum’s phloxine-tetrazine stain [51. One-millimeter segments of tissue were placed in 2.5% buffered gluteraldehyde, rinsed in cacodylate buffer (1 M), and fixed in 1% osmium tetroxide. Tissue was stained with uranyl acetate (10% in methyl alcohol) followed by lead citrate (0.28%) and was examined under an RCA EMU3 electron microscope. RESULTS

The cysts were lined by benign appearing mutinous epithelium with numerous goblet cells of the intestinal type. Paneth cells, containing eosinophilic granules, 1 To whom requests for reprints should be sent. 391 0090-8258/78/0064-0391$01.00/0 Copyright @ 1978 by Academic Press. Inc. All rights of reproduction in any form reserved.

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appeared both singly and in continuous rows among the goblet cells (Fig. 1). The granules were periodic acid-Schiff positive and were phloxinophilic with Lendrum’s stain. Electron microscopy of the Paneth cells revealed membrane-bound, electrondense granules with cores of linear, somewhat crystalline appearance (Fig. 2). The mucus-secreting epithelium contained membrane-bound, electron-light secretory granules (Fig. 3). DISCUSSION

Paneth cells are normally found in the depths of the crypts of the small intestinal mucosa. Their acidophilic granules contain a mucopolysaccharide-protein complex, the identity of which is not established but which may be related to intestinal enzymes [3]. Ultrastructurally, human Paneth cells are described [9] as containing granules which vary somewhat in density in different areas of a given cell and which are bounded by a distinct membrane. The matrix of the granules is said to be composed of particles varying from 50 to 200 A in width. The linear pattern seen in our material has not, to our knowledge, been described. Benign mutinous cysts of the ovary are lined by epithelium which resembles

FIG. 1. Paneth cells interspersed among goblet cells in the epithelium lining a cyst. The granules of the Paneth cells stain darkly in contrast to the almost clear mucus of the goblet cells. Hematoxylin and eosin: x 610.

PANETH

CELLS IN OVARIAN

MUCINOUS

CYSTADENOMA

393

FII3. 2. Electron micrograph of a Paneth cell. The membrane-bound granules (P) are seen, in the inset , to contain cores of variable density in a linear pattern resembling crystals. Surfac e membrane :ytosis (PI) can be seen close to the Paneth granules. N = Nucleus, x 2500, inset: x 12,500.

that of either the endocervix or the intestine [ 11. Paneth cells have only r;arely been desc:ribed [6,8]. In addition, argentaffin cells may be present in as many as 21% of muc inous tumors [2]. Masson and Theriault [7] demonstrated bile-secre :ting cells, and Hughesdon [4] found neuroglia in two mutinous ovarian tumors. SI lch obser-

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FIG. 3. The mucus-secreting epithelium. Membrane-bound and unbound mucus is in the form of electron-light granules in the cytoplasm (arrowheads), x 12,500.

vations led Scully [81 to suggest that certain of these tumors were of germ cell origin and represented elements of teratomas. REFERENCES I. Fenoglio, C. M., Ferenczy, A., and Richart, R. M. Mutinous tumors of the ovary. Ultrastructural studies of mutinous cystadenomas with histogenetic considerations, Cancer 36,1709- 1722 (1975). 2. Fox, H., Kazzaz, B., and Langley, F. A. Argyrophil and argentaffin cells in the female genital tract and in ovarian mutinous cysts, .I. Pathol. Bacterial. 88,479-488 (1964). 3. Greep, R. O., and Weiss, L. Histo/ogy, McGraw-Hill, New York, pp. 583-584 (1973). 4. Hughesdon, P. E. Structure and origin of ovarian tumors, Modern trends in gynecology (R. J. Kellar, Ed.), Butterworths, London, Vol. III, pp. 23-37 (1963). 5. Lendrum, A. C. The phloxine-tetrazine method as a histological stain and for the demonstration of inclusion bodies, J. Pathol. Bacterial. 59, 399-404 (1947). 6. Masson, P. Tumeurs Humaines, Librairie Maloine, Paris, p. 718 (1956). 7. Masson, P., and Theriault, J. P. Une forme inhabituelle de tumeur ovarienne. Epithelioma biliohepatoide, Ann. Anat. Pathol. 1, 7-18 (1956). 8. Scully, R. E. Germ cell tumors of the ovary, in Progress in gynecology (S. H. Sturgis and M. L. Taymor, Eds.), Grune and Stratton, New York, Vol. V, p. 343 (1970). 9. Trier, J. S. Studies on small intestine crypt epithelium. I. The fine structure of the crypt epithelium of the proximal small intestine of fasting humans, .I. Cell Biol. 18, 599-620 (1963).

Paneth cells in a mucinous cystadenoma of the ovary: light and electron microscopic study.

GYNECOLOGIC ONCOLOGY 6, 391-394 (1978) CASE REPORT Paneth BRADLEY Cells in a Mutinous Cystadenoma the Ovary: Light and Electron Microscopic Study...
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