Call Exner bodies

Call-Exner Bodies

Call-Exner bodies are small, round structures found in certain types of ovarian tumors, specifically granulosa cell tumors. These structures are named after Emma Louise Call and Sigmund Exner, who first described them in the late 19th century. Call-Exner bodies are considered a histopathological hallmark of granulosa cell tumors and are important for the diagnosis and study of these neoplasms.

Histology

Call-Exner bodies are characterized by their distinctive appearance under the microscope. They consist of small, round spaces filled with eosinophilic fluid and surrounded by a rosette of granulosa cells. The granulosa cells are typically arranged in a manner reminiscent of immature Graafian follicles, which are structures found in the ovary during the development of oocytes.

The presence of Call-Exner bodies is a key diagnostic feature when examining ovarian tissue suspected of harboring a granulosa cell tumor. These bodies are not found in other types of ovarian tumors, making them a useful marker for pathologists.

Pathophysiology

Granulosa cell tumors are a type of sex cord-stromal tumor that arise from the granulosa cells of the ovary. These tumors can produce estrogen, leading to symptoms related to hyperestrogenism, such as abnormal uterine bleeding or endometrial hyperplasia. The formation of Call-Exner bodies is thought to be related to the tumor's attempt to mimic normal follicular development, although the exact pathophysiological mechanisms remain under investigation.

Clinical Significance

The identification of Call-Exner bodies in a biopsy or surgical specimen can aid in the diagnosis of granulosa cell tumors. These tumors are generally considered to have a better prognosis than other types of ovarian cancer, but they can recur many years after initial treatment. Therefore, long-term follow-up is recommended for patients diagnosed with granulosa cell tumors.

Diagnosis

The diagnosis of granulosa cell tumors, and by extension the identification of Call-Exner bodies, is typically made through histological examination of ovarian tissue. A pathologist will look for the characteristic rosette-like structures surrounded by granulosa cells. Immunohistochemical staining may also be used to support the diagnosis, with markers such as inhibin, calretinin, and FOXL2 being commonly employed.

Treatment

The primary treatment for granulosa cell tumors is surgical removal of the tumor. Depending on the stage and extent of the disease, additional treatments such as chemotherapy or radiation therapy may be considered. The presence of Call-Exner bodies does not directly influence treatment decisions, but their identification helps confirm the diagnosis.

Prognosis

The prognosis for patients with granulosa cell tumors is generally favorable, especially when the tumor is detected early. However, due to the potential for late recurrence, ongoing surveillance is important. The presence of Call-Exner bodies is associated with granulosa cell tumors, which tend to have a better outcome compared to more aggressive ovarian cancers.

Also see

• Granulosa cell tumor
• Ovarian cancer
• Histopathology
• Sex cord-stromal tumor