Patient's question:
I would like to know what tests are needed for a follicular cyst.Doctor's answer:
(1) Hormone testing: Luteinizing hormone/Follicle-stimulating hormone ≥3 is diagnostically significant, with estrone levels often exceeding estradiol levels. Androgen levels are high, while progesterone levels are low. Luteinizing hormone and estradiol do not show the normal pre-ovulatory peak. Approximately 30% of patients also have elevated prolactin.(2) Gynecological examination: About 67% of patients can palpate one or both ovaries.
(3) Ovarian tissue biopsy reveals a capsule that is 2 to 5 times thicker than normal, with uneven thickness. The cortex contains follicles at varying stages of development, with diameters of about 2 to 6 mm, and a few reaching or exceeding 10 mm. Theca cell hyperplasia and luteinization are observed, with a lack or occasional presence of corpora lutea or corpora albicantia.
(4) Ultrasound: Both ovaries are larger than more than one-fourth of the normal uterus, containing multiple cystic follicles. Ultrasound-guided ovarian puncture aspirates purulent secretions, indicating acute ovarian inflammation.
(5) Laparoscopic examination: Ovarian cysts show a thickened capsule with a pearly appearance, with about 73% of cases having an uneven surface. About 80% of cases exhibit ovarian enlargement, 71% show multiple follicles scattered under the capsule, slightly protruding the ovary surface, and 64% have increased ovarian blood vessels.