Pathology · Female Genital and Breast Pathology

A 30-year-old woman has a unilateral ovarian mass. Histology shows tumor cells arranged in rosettes and festoons with hyaline globules. Cells are positive for CD99, WT1, and inhibin, and negative for EMA. Which is the most likely diagnosis?

  • A Granulosa cell tumor
  • B Small cell carcinoma of hypercalcemic type
  • C Endometrioid carcinoma
  • D Serous carcinoma
Correct answer: A. Granulosa cell tumor

Explanation

Adult granulosa cell tumor shows Call-Exner bodies (rosette-like structures with hyaline material) and cells with 'coffee bean' nuclei. It is positive for inhibin, WT1, CD99, and FOXL2, and negative for EMA. Small cell carcinoma of hypercalcemic type is positive for EMA and WT1 but negative for inhibin. Endometrioid carcinoma and serous carcinoma are EMA positive and inhibin negative.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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