Walthard cell rest

Walthard cell rests are benign histological findings typically located in the mesosalpinx or ovarian hilum. They are composed of transitional epithelium and are considered to be Müllerian duct remnants. These cell nests are named after the Swiss pathologist Max Walthard, who first described them in the early 20th century.

Histology

Walthard cell rests are characterized by small nests of epithelial cells that resemble urothelium, the transitional epithelium lining the urinary tract. These cells are often arranged in small clusters or nests and can be identified by their distinct morphological features:

• Cell Shape: The cells are typically round to oval with a moderate amount of cytoplasm.
• Nuclei: The nuclei are centrally located and can appear slightly grooved or indented.
• Cytoplasm: The cytoplasm is eosinophilic, meaning it stains pink with hematoxylin and eosin (H&E) stain.

Location

Walthard cell rests are most commonly found in the mesosalpinx, which is the fold of the peritoneum that supports the fallopian tubes. They can also be found in the ovarian hilum, the area where the ovary attaches to the broad ligament.

Clinical Significance

Walthard cell rests are generally considered to be benign and are often incidental findings during histopathological examination of the female reproductive system. They are not associated with any specific symptoms and do not require treatment. However, their presence can sometimes be confused with pathological conditions, such as:

• Brenner tumor: A rare ovarian tumor that also contains transitional epithelium.
• Transitional cell carcinoma: A malignant tumor that can arise in the urinary tract and occasionally in the ovary.

Pathogenesis

The exact origin of Walthard cell rests is not fully understood, but they are believed to be remnants of the Müllerian duct system. During embryonic development, the Müllerian ducts give rise to the fallopian tubes, uterus, and upper portion of the vagina. Walthard cell rests may represent ectopic or misplaced transitional epithelium from this developmental process.

Diagnosis

The diagnosis of Walthard cell rests is primarily made through histological examination. They are identified by their characteristic appearance under the microscope and their location in the mesosalpinx or ovarian hilum.

Differential Diagnosis

When examining Walthard cell rests, it is important to differentiate them from other conditions that may have similar histological features:

• Brenner tumor: Distinguished by its stromal component and more complex architecture.
• Transitional cell carcinoma: Identified by its invasive growth pattern and atypical cellular features.

Prognosis

Walthard cell rests are benign and have no malignant potential. They do not require any specific treatment and do not affect the overall prognosis of the patient.

See Also

• Müllerian duct
• Transitional epithelium
• Brenner tumor

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  Histology of a Walthard cell rest with coffee bean nuclei

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  Walthard cell rest - very low magnification

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  Walthard cell rest - very high magnification

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  Brenner tumour high magnification