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abstract
Ovarian epithelial inclusions lined by mucinous
epithelium are rare and of uncertain origin. Ovaries containing such
inclusions were studied in 42 women. The inclusions were divided into 3
groups: serous epithelial lined with typical ciliated morphology but
with distinct basophilic cytoplasmic mucin in some or all of the lining
cells, those lined by typical mucinous epithelium, and those lined by a
combination of typical mucinous epithelium and serous epithelium. The
mean patient age was 61.5 years. Pure mucinous inclusions were found in
27 patients, serous-type inclusions with cytoplasmic mucin in 20, and
mixed type in 10. All 3 types of inclusions were found in 1 patient. Two
types of inclusions were found in 13. Four patients had associated
mucinous neoplasms (1 mucinous cystadenoma, 1 atypical proliferative
seromucinous tumor, and 2 seromucinous cystadenomas), and 11 patients
(26%) had endometriosis. The fallopian tubes in 4 patients (9.5%) also
displayed mucinous metaplasia; this was not significantly different from
the 3.1% we found in our previously reported series of unselected tubes
from the same population. These findings suggest that mucinous
inclusions may arise as a direct metaplastic change in serous-type
inclusions. Other possible origins of mucinous inclusions in the ovarian
cortex include endometriosis and Brenner (transitional cell) nests.
Whether such inclusions can be a source of mucinous ovarian neoplasms as
are Brenner tumors and mature cystic teratomas is unknown and may
warrant further investigation.
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