What is the normal thickness of the ovaries?

The ovary is different from other organs in the female body. It is one of the organs closely related to reproductive function. The ovary is a gray-red, slightly flat, oval organ. The ovaries can produce and release eggs and secrete more than twenty hormones such as estrogen, progesterone, and androgen. They are not only organs that realize reproductive functions but also an important guarantee for ensuring other body functions. What is the normal thickness of the ovary?

The ovaries are the female reproductive glands, a pair of flat oval, grayish white, solid tissues with an uneven surface. The size and shape vary with age. It is about 4×3×1cm in an adult and weighs 5~6g. It gradually shrinks, becomes smaller and harder after menopause. The ovary can be divided into front and back sides, upper and lower edges, and inner and outer ends. The lateral end is close to the fallopian tube fimbria, and the medial end is connected to the uterine horn by the ovarian proper ligament; the lower edge is convex and free, and the upper edge is relatively straight. It is connected to the posterior lobe of the broad ligament by the ovarian mesentery to form the ovarian hilum, through which the blood vessels and nerves of the pelvic infundibulum ligament enter the ovary.

Generally speaking, the shape and size of the ovaries and endometrium change during the menstrual cycle, which is the main reason for menstruation. Therefore, there is no definite value to judge, but generally the maximum diameter of the ovaries will not exceed 4cm, and the thickness of the endometrium is generally thickest 2-3 days before menstruation. The thickness varies from person to person depending on the amount of menstruation, about 10-15mm.

The surface of the ovary is not covered by peritoneum, but is a single layer of columnar epithelium with a thick layer of fibrous tissue membrane underneath, called the ovarian white membrane. Further inward are the cortex and medulla. The cortex contains tens of thousands of follicles and dense connective tissue. The medulla is located in the center of the ovary. It has no follicles and is rich in blood vessels, lymph, nerves and loose connective tissue.

The normal thickness of the endometrium is 5-10MM. The thickness of the endometrium changes with the menstrual cycle and is not constant. Menstrual period: the functional layer of the endometrium is shed and the basal layer is retained; proliferative period: the thickness of the endometrium reaches 1-3mm within the 6th to 14th day of menstruation. Secretory phase: 15-28 days of menstruation, the endometrium is 5-7mm thick.

Common ovarian diseases:

Ovarian epithelial tumors: The age of onset is mostly between 30 and 60 years old. There are benign, borderline malignant and malignant types. Borderline malignant tumors refer to tumors with active epithelial cell proliferation and nuclear atypia, manifested by increased epithelial cell layers but no stromal infiltration. They are low-grade malignant tumors with slow growth, low metastasis rate and late recurrence.

1) Serous cystadenoma: common, accounting for about 25% of benign ovarian tumors. Most of them are unilateral, spherical, of varying sizes, smooth in surface, cystic, with thin walls, and filled with light yellow clear fluid. There are two types: simple and papillary. The former is mostly unilocular with smooth cystic walls; the latter is often multilocular with papillae visible inside, and occasionally grows outside the cyst. Microscopically, the cyst wall is composed of fibrous connective tissue, lined with a single layer of cubic or columnar epithelium, and psammoma bodies are seen in the interstitium, which are caused by calcium salt precipitation. The papillary branches are thicker.

Borderline malignant serous cystadenomas are medium-sized, mostly bilateral, and have papillary growth less often within the cyst and more often grow outside the cyst. Microscopically, the papillary branches were slender and dense, the epithelial stratification did not exceed 3 layers, the cell nuclei were slightly atypical, the mitotic rate was <1/1HP, and there was no interstitial infiltration. The 5-year survival rate is over 90%.

Serous cystadenocarcinoma is the most common ovarian malignancy, accounting for 40% to 50%. Most of them are bilateral, large in size, and semi-solid. Nodular or lobed, with a smooth surface, grayish white, or papillary hyperplasia, multi-chambered cross section, the cavity is filled with papillae, brittle, hemorrhagic, necrotic, and turbid cystic fluid. Microscopically, the cyst wall epithelium is significantly proliferative and arranged in stratified layers, usually with more than 4 to 5 layers. The cancer cells are cuboidal or columnar, with obvious cell atypia, and infiltrate into the interstitium. The 5-year survival rate is only 20% to 30%.

2) Mucinous cystadenoma: common, accounting for 20% to 30% of benign ovarian tumors. Most of them are unilateral, round or oval, smooth, grayish white, and large or huge in size. The cross section is often multilocular, and the cystic cavity is filled with gelatinous mucus containing mucin and glycoprotein. Rarely do nipples grow inside the cysts. Microscopically, the cyst wall is composed of fibrous connective tissue, lined with a single layer of tall columnar epithelium that produces mucus; goblet cells and argyrophilic cells are sometimes seen. The malignant transformation rate is 5% to 10%.

Mucinous cystadenomas may occasionally rupture on their own, and the mucinous epithelium implanted on the peritoneum continues to grow and secrete mucus, forming many jelly-like mucus clumps on the peritoneal surface, which look very similar to ovarian cancer metastasis. These masses are called peritoneal mucinous tumors, accounting for 2% to 5% of mucinous cystadenomas. The tumor cells are benign, secrete vigorously, rarely show cell atypia and nuclear division, and are mostly limited to growth on the peritoneal surface, generally not infiltrating the organ parenchyma.

Borderline malignant mucinous cystadenomas are generally larger, a few are bilateral, have a smooth surface, and are often multilocular. The cross section shows that the cyst wall is thickened, and the solid area and papillae are formed. The papillae are small and soft. Microscopically, the epithelium does not exceed 3 layers, the cells are mildly atypia, the nuclei are large and darkly stained, there is a small amount of nuclear division, the proliferating epithelium protrudes into the cavity to form short and thick papillae, but there is no interstitial infiltration.

Mucinous cystadenocarcinoma accounts for 10% of ovarian malignancies. It is more common on one side, with a larger tumor, visible papillary or solid areas on the cyst wall, half cystic and half solid on the cross section, and turbid or bloody cystic fluid. Microscopically, the glands are densely packed with less stroma, the glandular epithelium has more than 3 layers, the cells are obviously atypia, and there is stroma infiltration. The prognosis is better than that of serous cystadenocarcinoma, with a 5-year survival rate of 40% to 50%.

3) Ovarian endometrioid tumor: Benign tumor is less common. Most of them are unilocular, with a smooth surface and a cystic wall lined with a single layer of columnar epithelium, which resembles the normal endometrial glandular epithelium. The cyst is covered with squamous epithelium, and there may be hemosiderin-containing phagocytes in the interstitium. Borderline malignancies are rare.

Malignant ovarian endometrioid carcinoma accounts for 10% to 24% of primary ovarian malignant tumors. The tumor is mostly unilateral, medium in size, cystic or solid, with nipple growth, and the cystic fluid is mostly bloody. The microscopic features are very similar to those of endometrial carcinoma, mostly adenocarcinoma or adenoacanthoma, and often complicated by endometrial carcinoma, making it difficult to distinguish which is primary or secondary. The 5-year survival rate is 40% to 50%.