Corpus luteal cyst
A corpus luteal (CL) cyst is a type of functional ovarian cyst which results when a corpus luteum fails to regress following the release of an ovum. When associated with pregnancy, it is the most common pelvic mass encountered within the 1st trimester 1.
The natural history of a normal corpus luteum is to regress - by the end of the 1st trimester if pregnancy has occurred. If a corpus luteum fails to regress, and instead enlarges with or without haemorrhage, a corpus luteum cyst is formed. There is some overlap in the definitions of a corpus luteum cyst versus haemorrhagic corpus luteum 5.
When associated with pregnancy, most corpus luteal cysts spontaenously involute at the end of the 2nd trimester.
They can have a range of sonographic appearances depending on the stage of evolution and age of the associated intracystic haemorrhage 3.
If the cyst has been present for some time with complicating haemorrhage, a fine internal lace like echo-pattern may be seen.
Colour Doppler interrogation show either no vascularity within the cyst or at times show low resistance blood flow around the cyst also known as hypervascular ''ring of fire''.
- low-attenuating (25HU) cyst, <3cm in diameter with thick, slightly irregular and iso- or hyper-dense walls 6
- free fluid is often associated 6
Often seen as a round or oval adenxal lesion
- T1 - typically homogeneously hypo intense 1
- T2 - typically hyper intense 1-2
- T1 C+ (Gd) - intense wall enhancement may be seen 1
- haemorrhage - haemorrhagic corpus luteal cyst
It can be difficult to differentiate from a tubal ring in an ectopic pregnancy in some situations and correct clinical interpretation is often required.
- 1. Jung SE, Byun JY, Lee JM et-al. MR imaging of maternal diseases in pregnancy. AJR Am J Roentgenol. 2001;177 (6): 1293-300. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999;212 (1): 5-18. Radiology (full text) - Pubmed citation
- 3. Merz E. Ultrasound in obstetrics and gynecology, Gynecology. Thieme Publishing Group. (2007) ISBN:3137544025. Read it at Google Books - Find it at Amazon
- 4. Swire MN, Castro-aragon I, Levine D. Various sonographic appearances of the hemorrhagic corpus luteum cyst. Ultrasound Q. 2004;20 (2): 45-58. Ultrasound Q (link) - Pubmed citation
- 5. Potter AW, Chandrasekhar CA. US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients. Radiographics. 2008;28 (6): 1645-59. doi:10.1148/rg.286085504 - Pubmed citation
- 6. Borders RJ, Breiman RS, Yeh BM et-al. Computed tomography of corpus luteal cysts. J Comput Assist Tomogr. 2004;28 (3): 340-2. Pubmed citation
Synonyms & Alternative Spellings
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