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Tumor Discovery Immunohistochemistry profiling of ovarian cysts

around menarche, due to increased endogenous hormone formation of follicular cysts. Another molecular hypothesis
production. Their asymptomatic nature complicates early suggests that mutations in oncogenes, such as KRAS and
1-3
detection, which could have enhanced clinical management BRAF, activate the MAPK signaling pathway, contributing
11
and improved patient outcomes. Consequently, ovarian to cyst development. In addition, ovarian cysts may also
cysts are often diagnosed at a later stage, negatively arise from the exposure of ovarian surface epithelial cells
impacting therapeutic options and patient outcomes. These to inflammatory cytokines, such as interleukin-6, and
ovarian masses can significantly affect the reproductive reactive oxygen species linked to ovulation or physical
vibrancy of women, survival, and overall health status. trauma, resulting in DNA damage. 12
4,5
Ovarian cysts are broadly grouped into functional
(physiological) and non-functional (pathological) cysts. 4. Classification of ovarian cysts
Functional cysts include follicular and luteal cysts, while Ovarian cysts are classified into functional (physiological)
pathological cysts are further classified into benign and and non-functional (pathological) cysts. The World
malignant cysts. Benign cysts often resolve spontaneously Health Organization’s histological classification includes
6
and require minimal intervention, whereas malignant cysts benign, malignant, and metastatic cysts based on their
engender prompt and aggressive treatment. An accurate histogenesis. Functional cysts include follicular and luteal
7
10
diagnostic distinction between benign and malignant cysts, which are typically self-limiting and may require less
ovarian cysts is significant for definitive patient treatment therapeutic intervention. In contrast, pathological cysts,
and outcomes. Immunocytochemistry (ICC) plays a key further classified into benign and malignant cysts, require
role in distinguishing between benign and malignant prompt and aggressive therapeutic interventions due to
ovarian lesions. This diagnostic technique uses antibodies their life-threatening potential. 7
to detect and visualize specific cellular antigens (proteins) in
cytology specimens, offering detailed and distinct cellular 4.1. Physiological cysts
and molecular insights on tissues. Clinical manifestations Functional cysts: These cysts are non-neoplastic masses
8
of ovarian cysts may include pelvic and abdominal pain, or enlargements (<3 mm) in women of reproductive
bloating, and menstrual irregularities. Complications such years. They are the most common type of cysts during the
as ovarian torsion (twisting of the ovaries) and rupture menstrual cycle and arise due to either ovulation failure
can arise, underscoring the need for timely diagnosis and or corpus luteum formation. In cases of ovulation failure,
management. This review explores the diagnostic role cysts that form are lined by granulosa cells, persisting for a
9
of ICC in distinguishing between benign and malignant few days to a few weeks. The corpus luteum is formed from
ovarian lesions.
follicular remnants after ovulation and can develop into a
2. Scope and methodology of the review cyst if it fails to dissolve within 14 days. Hyper-physiological
ovarian response induces the development of functional
The research strategy for this review involved a systematic cysts, such as the follicular, corpus luteum, and theca-
and integrative approach encompassing literature lutein cysts. 14,15
collection, data extraction, synthesis, and analysis. This
strategy ensured a thorough exploration of the topic across Follicular cysts: These are ovarian cysts that are formed
multiple perspectives. Key biomedical, public health, and when ovulation fails to occur, causing the follicles to grow
imaging databases such as PubMed, Scopus, Web of Science, without releasing a matured ovum. Histopathologically,
and EMBASE were used. The search strategy incorporated follicular cysts are characterized by thin walls and pale
specific keywords and Medical Subject Headings terms acidophilic remnants. They often contain pigmented
related to ovarian cancer and tumor markers. macrophages, degenerated oocytes, and cellular debris.
Follicular cysts are lined by one to four layers of cuboidal
3. Pathogenesis of ovarian cysts granulosa cells without luteinization 15,16 (Figure 2).
The pathogenesis of ovarian cysts remains poorly Corpus luteum cysts: These are ovarian cysts that occur
understood, though several established hypotheses after successful ovulation, when the follicle releases the
suggest a complex interplay of hormonal, molecular, ovum, leading to the formation of corpus luteum from
immunological, and environmental factors (Figure 1). the follicular remnants (Figure 3). The corpus luteum is
One of the most common hypotheses involves alterations responsible for secreting progesterone. If fluid accumulates
in the regulation of hormones associated with ovulation, inside the corpus luteum and it fails to dissolve within
10
particularly disruptions in the hypothalamus-pituitary axis 14 days of no pregnancy or 14 weeks after pregnancy, it
that impair the adequate release of luteinizing hormone. enlarges into a cyst. These cysts are characterized by thick
This deficiency can prevent ovulation, leading to the walls and are lined by many layers of luteinized granulosa

Volume 4 Issue 1 (2025) 15 doi: 10.36922/td.5369