HISTOLOGY AND CYTOLOGY OF LAPAROSCOPICALL Y OPERATED SIMPLE OVARIAN CYSTS

In a retrospective study the histopathological findings of 127 laparos copically operated unilocular anechoic smooth-walled ovarian cysts hav e been correlated with clinical characteristics (age, duration of obse rvation, complaints, hormonal treatment), size by ultrasound, kind and colour of cysts content as well as cytological findings. The age of p atients differed from 16-61 years ((x) over bar+s: 36+/-16). The histo pathologic findings yielded 15 (11.8 %) functional cysts, 30 (23,6 %) persistent corpus luteum cysts, 9 (7,1 %) endometriomas, 7 (5.5 %) cys tic teratomas, 9 (7.1 %) undifferenciated cysts and 57 (44,9%) cystade nomas. There were no differences between histopathologic diagnosis gro ups according to age and cysts size by ultrasound. Functional cysts wi th complaints (n = 6) may explain that the observation time in 60 % of all functional cysts was smaller than 6 weeks, whereas persistent cor pus luteum cysts, endometriomas, cystic teratoma and cystadenomas had been observed for longer than 6 weeks in more than two thirds. Intraop erative evaluation of cysts content as ''chocolate''-like was suspicio us of endometriomas, but was also present in cysts of other histopatho logical findings. By means of cytology, endometrioma (siderophages) wa s suspected in 44.4 % and a cystadenoma in 42.1 % of all histopatholog ically verified cases. In all, the cytologic findings were useful for correct histopathological diagnosis in only 33.9 % of all 127 cases. I t is concluded that differential diagnosis of simple ovarian cysts is not possible by clinical characteristics, neither by ultrasound nor by cytological evaluation. Ovarian cysts should be observed for at least two hormonal cycles. A hormonal treatment by combination preparations containing high doses of oestrogen is also recommended. In cases of p ersisting ovarian cysts laparoscopic removal is necessary.