For anyone looking for more info:
Page 147 of Pathoma
3 types of Sex cord tumors: Granulosa-theca (follicle cells), Sertoli-Leydig, and fibroma.
G-T tumor: estrogen excess
S-L tumor: androgen excess
Fibroma: benign, fibroblasts, cause meig's syndrome
I think what threw me off was the fact that it said "most likely" and Sertoli-Leydig cell tumor in a female just seemed like such a rarity that I figured it had to be some cells females typically have.
Keeping this in mind for future questions. If one of the answers actually fits the bill, don't pick one that you're not sure of because the correct one seems unlikely! *bangs head
Wyh si ti otn aanrvio ileclolf ?slecl I htoguht hte ealefm aangol fo eoitlrS nda idgLye is ala/eosaurtnchg e.slcl
I think its also help to eliminate the other answers.
Adrenal fasciulata cells (producing adrenal androgens) can be eliminated b/c this pt has adrenal androgens in the normal ranges. If you wanted to make the leap that adrenal androgens could be peripherally converted to stronger androgens (testosterone/DHT), then the inciting adrenal androgens should also be elevated.
Glomerulosa: would produce aldosterone. Though we aren't given her aldo levels, her Sx wouldn't match a Conn's syndrome picture.
Ovarial Follicle cells: have the enzymatic machinery to produce androstenedione (theca cells, its downstream cholesterol product, DHEA, is not elevated) and estrogen (granulosa cells), which doesn't fit the clinical picture this pt has.
Acidophilic hormones (prolactin/GH) are not consistent with this pt clinical picture (like gigantism, galactorrhea)
Basophil (all the others) again, not consistent, even with the gonadotropic cells, since we see LH is low. That leaves you with (D), which as others have pointed out, is consistent with this pt's presentation.