Corpus luteal cyst

Corpus luteal (CL) cysts are a type of functional ovarian cyst that result 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. There is also some overlap with the term "haemorrhagic corpus luteum ".

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 and a haemorrhagic corpus luteum 5.

Natural course

When associated with pregnancy, most corpus luteal cysts spontaneously involute at the end of the 2nd trimester.

Ultrasound

They can have a range of sonographic appearances depending on the stage of evolution and age of the associated intracystic haemorrhage 3. General characteristics include 7:

  • diffusely thick wall
  • peripheral vascularity
  • <3 cm
  • possible crenulated contour

If the cyst has been present for some time with complicating haemorrhage, a fine internal lace like echo-pattern may be seen.

Colour Doppler shows either no vascularity within the cyst or show lows resistance blood flow around the cyst also known as hypervascular ''ring of fire''.

CT
  • low-attenuating cyst (25 HU)
  •  <3 cm in diameter with thickened walls
  • slightly irregular cyst
  • iso- or hyperattenuating walls 6
  • free fluid is often associated 6
MRI

Often seen as a round or oval adnexal lesion.

  • T1: typically homogeneously hypointense 1
  • T2: typically hyperintense 1-2
  • T1 C+ (Gd): intense wall enhancement may be seen 1

For a corpus luteum ≤3 cm, no follow up is necessary 7.

Complications

It can be difficult to differentiate from a tubal ring in an ectopic pregnancy in some situations, and correct clinical interpretation is often required.

Share article

Article information

rID: 10447
System: Gynaecology
Section: Pathology
Synonyms or Alternate Spellings:
  • Corpus luteum cyst
  • Corpus luteal (CL) cyst
  • Corpus luteal cysts
  • Corpus luteum cysts
  • Corpus luteal (CL) cysts
  • Cystic corpus luteum

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    3
    Case 1: haemorrhagic corpus luteal cyst
    Drag here to reorder.
  • Drag
    Case 2: with rupture
    Drag here to reorder.
  • Drag
    Case 3: MRI
    Drag here to reorder.
  • Drag
    Case 4: CT
    Drag here to reorder.
  • Drag
    Case 5: PET-CT
    Drag here to reorder.
  • Drag
    "Ring of fire" ar...
    Case 6: classic "ring of fire" appearance
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.