Call–Exner bodies

Call-Exner bodies

Call–Exner bodies are distinctive microscopic features observed in the granulosa cells of the ovary, particularly within certain types of ovarian tumors, most notably granulosa cell tumors. These structures are named after the pathologists Eduard Call and Sigmund Exner who first described them in the late 19th century. Call–Exner bodies are considered important in the histopathological diagnosis of ovarian tumors.

Characteristics

Call–Exner bodies are small, round to oval spaces or cavities found within the granulosa cell layers of the ovary. These spaces are surrounded by granulosa cells that are arranged in a rosette-like pattern. The cavities often contain eosinophilic (acidic dye-staining) material, which may include fragments of basement membrane, glycoproteins, and other cellular debris. The presence of Call–Exner bodies is indicative of an active folliculogenesis process, where these structures mimic the early stages of follicle development and the formation of the antrum in normal ovarian follicles.

Pathological Significance

The identification of Call–Exner bodies is particularly significant in the diagnosis of granulosa cell tumors, a type of sex cord-stromal tumor of the ovary. These tumors are rare and can produce estrogen, leading to symptoms of hormonal imbalance such as endometrial hyperplasia, irregular menstrual cycles, and postmenopausal bleeding. The presence of Call–Exner bodies, along with other histological features such as nuclear grooves and coffee bean nuclei in granulosa cells, helps in distinguishing granulosa cell tumors from other ovarian neoplasms.

Clinical Implications

Granulosa cell tumors, while rare, are important to diagnose accurately due to their potential for hormone production and the implications for patient management. These tumors can recur many years after initial treatment, making long-term follow-up essential. The identification of Call–Exner bodies can aid in the correct diagnosis and appropriate management of these tumors, including surgical removal and hormonal therapy, if indicated.

Research and Future Directions

Research into Call–Exner bodies and granulosa cell tumors continues to evolve, with studies focusing on the molecular and genetic underpinnings of these tumors. Understanding the pathogenesis of granulosa cell tumors and the role of Call–Exner bodies may lead to improved diagnostic markers and therapeutic targets.