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Hyperreactio Luteinalis : Causes

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Introduction: Hyperreactio luteinalis (HL) refers to bilateral ovarian enlargement due to the development of numerous luteinized follicular cysts.

Causes: It is usually seen in conditions associated with elevated hCG levels, including gestational trophoblastic disease (hydatidiform mole, choriocarcinoma), fetal hydrops, multiple gestations, and polycystic ovary syndrome. HL is seen in 10% to 40% of patients with gestational trophoblastic disease. An iatrogenic form of HL is seen patients receiving FSH and hCG or clomiphene for ovulation induction (ovulation hyperstimulation syndrome). A small percentage of patients have normal singleton pregnancy and no underlying causes.

The image shows thin walled follicular cysts lined by luteinized theca interna and granulosa cells. The interfollicular stroma is edematous and may also contain luteinized stromal cells.

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