By Anna Sienko
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Additional resources for Advances in Surgical Pathology: Endometrial Carcinoma
Chapter 3 • Endometrial Hyperplasia 19 FIGURE 3-2: Endometrial epithelium usually demonstrates proliferative features such as pseudostratification and mitoses (arrows). FIGURE 3-3: Secretory changes in endometrial hyperplasia. 20 Section II • Histopathology Simple versus Complex Endometrial Hyperplasia Simple endometrial hyperplasia is characterized by a proliferation of dilated endometrial glands of variable size, with no or slight outpouchings (Fig. 3-4), whereas in complex endometrial hyperplasia, the endometrial glands are markedly irregular in size and shape with numerous outpouchings (Fig.
Occasionally, squamous morules have central keratinization or necrosis (Fig. 24 Nuclear features can be bland or obviously atypical. The former can be seen in association with normal endometrium, hyperplasia, or carcinoma, whereas the latter is usually seen in high-grade endometrioid adenocarcinoma or in the rare cases of squamous carcinoma arising in the endometrium. 34 Section II • Histopathology FIGURE 3-18: Squamous metaplasia. 25 However, ciliated cells also can be noted within glands in endometrium stimulated by unopposed estrogen5 or in inactive endometrium (unpublished personal observation).
Diagnosing endometrial hyperplasia. Why is it so difficult to agree? Am J Surg Pathol. 2008;32:691–698. Chapter 3 • Endometrial Hyperplasia 39 20. Zaino RJ, Kauderer J, Trimble CL, et al. Reproducibility of the diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106:804–811. 21. Baak JP, Mutter GL, Robboy S, et al. The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system.
Advances in Surgical Pathology: Endometrial Carcinoma by Anna Sienko