Hemorrhagic corpus luteal cyst

Hemorrhagic corpus luteal cysts result from bleeding into corpus luteal cysts.

Radiographic features

Ultrasound

Commonly described findings include:

• complex adnexal mass
• adnexal thick-walled cystic lesion with lace-like strands
• adnexal thick-walled cystic lesion with low-level echoes within
• peripheral vascularity: ring of fire sign
• follow up ultrasound is suggested in about 2 menstrual cycles or ~ 6 weeks, especially to differentiate from an endometrioma

CT

• thick walled peripherally enhancing cystic lesion
• high attenuation component (45-100 HU)
• “fluid-fluid hematocrit” level

Differential diagnosis

For ultrasound appearances consider:

• other hemorrhagic ovarian cysts
  • hemorrhagic follicular cyst 
• on certain occasions, an endometrioma can have overlapping imaging features