Polycystic ovaries are characterized by bilaterally enlarged polycystic ovaries, chronic anovulation and clinical manifestations due to secretion of excess androgens. LH in turn stimulates the ovary to produce excess androgens. Other patients may be amenorrheic but otherwise normal. Both ovaries are markedly enlarged and have a thickened, fibrotic capsule with smooth pearl-white surfaces. Polycystic ovary showing the smooth pearl-white capsular surfaces.
Cysts bulge out.
Histology Microscopically, the outer portion of the cortex is thickened and fibrotic and many follicle cysts are present in the subcapsular cortex. The cysts have prominent outer theca interna layer, which is often luteinized. Corpora lutea are frequently absent due to the anovulation and occasional focal stromal luteinization is present. The chronic anovulation results in unopposed estrogenic stimulation of the endometrium leading to a variety of appearances ranging from mild atypical hyperplasia to well-differentiated endometrial adenocarcinoma. Polycystic ovary with two subcapsular follicular cysts.