Call-Exner bodies

Call-Exner bodies are small, eosinophilic, fluid-filled spaces found within the granulosa cells of the ovary in certain conditions, most notably in Granulosa cell tumors and in the follicles of individuals with polycystic ovary syndrome (PCOS). These structures are named after the pathologists Eduard Call and Otto Exner, who first described them in the late 19th century.

Call-Exner bodies are considered to be a diagnostic feature when identifying granulosa cell tumors, which are a type of sex cord-stromal tumor of the ovary. These tumors can produce estrogen, leading to symptoms of hyperestrogenism, such as endometrial hyperplasia, abnormal uterine bleeding, and in some cases, endometrial cancer.

In the context of PCOS, the presence of Call-Exner bodies may be indicative of the disorder's effect on folliculogenesis. PCOS is characterized by a hormonal imbalance that can interfere with the development and release of eggs from the ovaries. The appearance of Call-Exner bodies in this condition suggests an abnormality in the maturation of follicles, which is a hallmark of PCOS.

Histologically, Call-Exner bodies are seen as round to oval spaces surrounded by granulosa cells, which are the cells that line the follicle and are responsible for nurturing the developing oocyte. These spaces are thought to result from the premature luteinization or atresia of follicles, processes that are disrupted in conditions like granulosa cell tumors and PCOS.

The identification of Call-Exner bodies can be crucial in the histopathological diagnosis of ovarian conditions. Their presence, along with other histological and clinical findings, can help differentiate granulosa cell tumors from other ovarian neoplasms and can also provide insight into the pathophysiology of PCOS.