Question

What is the function of the hilus cells?

Answer 1

“Hilus cell heterotopia accompanying bilateral ovarian serous cystadenomas: a case report and review of the literature

Hong-Lin He, Ying-En Lee, Chi-Chang Chang

Additional article information

Abstract

Hilus cell heterotopia is the presence of normal hilus cells in an abnormal site. It is rare and there are only a few case reports or case series. It has been reported in the fimbrial stroma of the fallopian tube, paratubal cyst wall and beneath ovarian capsule. Most cases are more than 40 years of age, and some of them are associated with other underlying pelvic pathology. Hilus cells are ovarian counterpart of testicular Leydig cells, carrying similar morphological and immunohistochemical findings. In this report, we described a patient having bilateral serous cystadenomas with an incidental finding of hilus cells in the fallopian tube.

Keywords: Hilus cell heterotopia, hilus cell rests
Introduction

The ovarian hilus cells are found in the ovarian hilum and mesovarium, often adjacent to nerves [1]. They resemble Leydig cells of the testis and contain lipofuscin pigments and occasional Reinke crystals. They have epithelioid morphology with round to oval, vesicular nuclei, prominent nucleoli, and abundant granular eosinophilic cytoplasm [2]. The histogenesis of hilus cells is unknown, which may be derived either from luteinized ovarian stromal cells that have wandered into the hilum or from perineural fibroblasts [3,4]. Hilus cell heterotopia is rare and often an incidental finding during pathological examination. In review of the literature, heterotopic hilus cells are identified in the fimbrial stroma of the fallopian tube, paratubal cyst wall or beneath ovarian capsule [5]. It often accompanies with other gynecologic abnormality, such as endometriosis, salpingitis isthmica nodosa and neoplasm. None of the cases reported in the literature were associated with a bilateral ovarian neoplasms. We present a patient having bilateral serous cystadenomas with an incidental finding of hilus cells heterotopia in the fallopian tube. Detailed morphological and immunohistochemical studies are also performed.

Case report

The patient was a 60 year-old woman who suffered from lower abdominal pain. The gynecologic ultrasound scan showed bilateral ovarian cysts measuring 2.6 cm in diameter in the right side and 9.5 cm in diameter in the left side, respectively. The tumor markers, including CEA, CA125 and CA199 were within normal range. She received bilateral salpingo-oophorectomy. And the specimens were sent for pathological examination.”

Answer 2

Answer: Hilar cells resemble like Leydig cells of Testis , produce steroids, contain Reinke crystalloids, lipids, lipochrome pigments. They also resemble steroid cells by EM with microtubular smooth endoplasmic reticulum, mitochondria with a tubular cristae. Hilar cells are seen in the fetal ovary but not in infancy and childhood.They reappear at puberty.

Step-by-step explanation:

Hilus cells are androgen producing cells found in the ovarian hilum. It is analogous to the male Leydig Cells. They are found in the ovarian hilum and mesovarium often adjacent to nerves.•Closely associated with large hilar veins and lymphatics and may protrude within their lumina; also associated with nerves. They also produce masculine like tumours.