Qap (Anatomical Pathology) 

Case: AP235
Contributor's Comment: The given section shows the tumor is predominantly cystic and lined by granulosa cells with formation of many secondary, irregular and well punched out smaller follicles containing basophilic secretions (mucicarminophilic). The granulosa cells have abundant eosinophilic or vacuolated (luteinized) cytoplasm. The nuclei are rounded, generally non-grooved with nucleoli readily seen and occasional mitotic figures. The granulosa cells are immunoreactive for inhibin, calretinin and CD99. Distinction from adult type granulosa tumor (AGCT) is on the grounds of the well punched out secondary follicles and a paucity of nuclear grooves in JGCT; the cytologic features of the granulosa cells in AGCT are usually more epithelioid-looking, less cytoplasm with a typical dark-blue morphology of cells. Sex cord tumor with annular tubules may be composed of a mixture of simple and complex annular tubules with eosinophilic hyaline bodies which are often calcified. Simple annular tubules are ring shaped, with peripheral oriented nuclei around a central hyalinized body composed of basement membrane material. One third of these cases have Peutz-Jegherˇ¦s syndrome.