A 35-year-old woman presents with virilization and a solid ovarian mass. Histology shows cells with abundant eosinophilic cytoplasm containing Reinke crystals, arranged in sheets. What is the most likely diagnosis?
- A Sertoli-Leydig cell tumor
- B Stromal hyperthecosis
- C Steroid cell tumor (Leydig cell tumor) ✓
- D Krukenberg tumor
Correct answer: C. Steroid cell tumor (Leydig cell tumor)
Explanation
Reinke crystals are pathognomonic of Leydig cell tumors, a steroid cell tumor of the ovary that causes virilization by producing androgens. These cells have abundant eosinophilic cytoplasm. Sertoli-Leydig cell tumors show tubular structures and lack Reinke crystals. Stromal hyperthecosis is a bilateral stromal change, not a discrete mass. Krukenberg tumor does not cause virilization.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.