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Differential Diagnosis of Ovarian Carcinoids: The differential diagnosis includes: granulosa cell tumor, Sertoli-Leydig cell tumor, neuroendocrine carcinoma, and metastatic carcinoid. These entities and features supporting them over ovarian carcinoid are discussed below.

Granulosa Cell Tumor: nuclear grooves, positivity for inhibin, calretinin and WT1; negative for EMA, neuroendocrine markers; absence of salt and pepper chromatin

Sertoli Cell Tumors and Sertoli-Leydig Cell Tumors: tubules of Sertoli cell tumors are more well-defined; presence of Leydig cells in Sertoli-Leydig cell tumors

Neuroendocrine Carcinoma: Large cell neuroendocrine carcinoma metastatic to the ovary should be ruled out. They have greater nuclear pleomorphism and a high Ki67 proliferation index.

Image 159 of 183