View source for Atypical polypoid adenomyoma of the uterus

{{ Infobox diagnosis
| Name       = {{PAGENAME}}
| Image      = Atypical_polypoid_adenomyoma_-_very_high_mag.jpg 
| Width      =
| Caption    = Atypical polypoid adenomyoma. [[H&E stain]]. 
| Synonyms   =
| Micro      = endometrial glands with irregular (non-ovoid) shapes, benign smooth muscle around the glands, morular squamous metaplasia
| Subtypes   =
| LMDDx      = [[endometrioid endometrial carcinoma]], [[endometrium with squamous morules]], [[endocervical adenocarcinoma]]
| Stains     =
| IHC        =
| EM         =
| Molecular  =
| IF         =
| Gross      = lower uterine segment lesion
| Grossing   =
| Site       = [[uterus]]
| Assdx      =
| Syndromes  =
| Clinicalhx = reproductive age women
| Signs      =
| Symptoms   =
| Prevalence = rare
| Bloodwork  =
| Rads       =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx         =
}}
'''Atypical polypoid adenomyoma of the uterus''' is a rare benign lesion of the [[uterus]].

It is usually referred to simply as '''''atypical polypoid adenomyoma''''' (abbreviated '''APA''').

==General==
*Very rare.<ref name=pmid21684185>{{Cite journal  | last1 = Terada | first1 = T. | title = Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases. | journal = Ann Diagn Pathol | volume = 15 | issue = 5 | pages = 338-41 | month = Oct | year = 2011 | doi = 10.1016/j.anndiagpath.2011.03.008 | PMID = 21684185 }}</ref>
*Benign.<ref name=pmid17050990/>
*Reproductive age women.

==Gross==
*Lower uterine segment.

==Microscopic==
Features:<ref name=pmid17050990>{{Cite journal  | last1 = Jakus | first1 = S. | last2 = Edmonds | first2 = P. | last3 = Dunton | first3 = C. | last4 = Holland | first4 = G. | title = Atypical polypoid adenomyoma mimicking cervical adenocarcinoma. | journal = J Low Genit Tract Dis | volume = 6 | issue = 1 | pages = 33-8 | month = Jan | year = 2002 | doi =  | PMID = 17050990 }}</ref>
*Glands with irregular (non-ovoid) shapes.
*Benign smooth muscle around the glands - '''key feature'''.
*Morular squamous metaplasia - balls of squamous cells - very common.
*Nuclear atypia (mild).

DDx:
*[[Endometrioid endometrial carcinoma]].
*[[Endometrium with squamous morules]] - more common.
*[[Endocervical adenocarcinoma]].

===Images===
<gallery>
Image:Atypical_polypoid_adenomyoma_-_intermed_mag.jpg | APA - intermed. mag. (WC)
Image:Atypical_polypoid_adenomyoma_-_high_mag.jpg | APA - high mag. (WC)
Image:Atypical_polypoid_adenomyoma_-_very_high_mag.jpg | APA - very high mag. (WC)
</gallery>
www:
*[http://www.pathologypics.com/PictView.aspx?ID=1220 APA (pathologypics.com)].

==IHC==
Features (glandular component):<ref name=pmid21684185/>
*AE1/AE3 +ve.
*CK7 +ve.
*ER +ve.
*PR +ve.

Significant negative (glandular component):<ref name=pmid21684185/>
*[[CK20]] -ve.
*CEA -ve.

==Sign out==
<pre>
ENDOMETRIUM, CURETTAGE:
- ATYPICAL POLYPOID ADENOMYOMA.

COMMENT:
Atypical polypoid adenomyomas are considered to be benign lesions; however, 
they may persist or recur in up to half of patients.
</pre>

==See also==
*[[Uterine tumours]].

==References==
{{Reflist|2}}

[[Category:Gynecologic pathology]]
[[Category:Diagnosis]]