Disordered proliferative endometrium - Revision history

Alessandro: /* General */

2019-02-13T12:41:41Z

General

← Older revision		Revision as of 12:41, 13 February 2019
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	Image:		Image:
	*[http://www.jabfm.org/content/19/6/590/F8.expansion.html Treatment ~~algorithim~~ based on endometrial biopsy results (jabfm.org)].<ref name=pmid17090792/>		*[http://www.jabfm.org/content/19/6/590/F8.expansion.html Treatment algorithm based on endometrial biopsy results (jabfm.org)].<ref name=pmid17090792/>

	==Microscopic==		==Microscopic==

Michael: /* Microscopic */

2014-06-18T12:15:57Z

Microscopic

← Older revision		Revision as of 12:15, 18 June 2014
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	**Stroma: cellular, stroma (spindle cells), mitoses.		**Stroma: cellular, stroma (spindle cells), mitoses.
	*[[Simple endometrial hyperplasia]] without atypia - architectural atypia diffuse.		*[[Simple endometrial hyperplasia]] without atypia - architectural atypia diffuse.
	*[[Benign endometrial polyp]].		*[[Benign endometrial polyp]] - may have gland dilation.
			*[[Anovulatory endometrium]] - some consider this a synonym, see ''[[relation to disordered proliferative endometrium]]''.

	===Images===		===Images===

Michael at 01:32, 1 May 2014

2014-05-01T01:32:07Z

← Older revision		Revision as of 01:32, 1 May 2014
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	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms =
	\| Prevalence =		\| Prevalence =
	\| Bloodwork =		\| Bloodwork =
	\| Rads =		\| Rads =
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	\| Other =		\| Other =
	\| ClinDDx =		\| ClinDDx =
	\| Tx =		\| Tx = followup - re-biopsy
	}}		}}
	'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium\|endometrial]] finding with some features of [[simple endometrial hyperplasia]].		'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium\|endometrial]] finding with some features of [[simple endometrial hyperplasia]].

Michael: +infobox, +images

2014-05-01T01:29:16Z

+infobox, +images

← Older revision		Revision as of 01:29, 1 May 2014
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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Disordered proliferative endometrium -- low mag.jpg
			\| Width =
			\| Caption = Disordered proliferative endometrium. [[H&E stain]].
			\| Synonyms =
			\| Micro = proliferative endometrial glands (pseudostratified nuclei + mitoses) with focally abnormal glands (glands >2x normal size; irregular shape -- typically with inflection points; >4 glands involved (dilated)), +/-stromal condensation, gland-to-stromal ratio normal, not within an endometrial polyp
			\| Subtypes =
			\| LMDDx = [[proliferative phase endometrium]],[[simple endometrial hyperplasia]], [[benign endometrial polyp]]
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[endometrium]]
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence =
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis = benign
			\| Other =
			\| ClinDDx =
			\| Tx =
			}}
	'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium\|endometrial]] finding with some features of [[simple endometrial hyperplasia]].		'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium\|endometrial]] finding with some features of [[simple endometrial hyperplasia]].

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	***Glands >2x normal size - usually 3-4x normal.		***Glands >2x normal size - usually 3-4x normal.
	***Irregular shape, e.g. gland contour has inflection points.		***Irregular shape, e.g. gland contour has inflection points.
	***Greater than ~~fours~~ glands involved (dilated).		***Greater than four glands involved (dilated).
	*+/-Stromal condensation -- balls of stromal tissue, aka "blue balls" (due to breakdown of endometrium).		*+/-Stromal condensation -- balls of stromal tissue, aka "blue balls" (due to breakdown of endometrium).

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	===Images===		===Images===
			<gallery>
			Image: Disordered proliferative endometrium -- low mag.jpg \| DPE - low mag.
			Image: Disordered proliferative endometrium -- intermed mag.jpg \| DPE - intermed. mag.
			Image: Disordered proliferative endometrium - alt -- intermed mag.jpg \| DPE - intermed. mag.
			Image: Disordered proliferative endometrium -- high mag.jpg \| DPE - high mag.
			Image: Disordered proliferative endometrium - alt -- high mag.jpg \| DPE - high mag.
			</gallery>
			<gallery>
			Image:Endometrial_stromal_condensation_high_mag.jpg \| Endometrial stromal condensation - high mag. (WC/Nephron)
			</gallery>
	www:		www:
	*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig15 DPE (sciencedirect.com)].		*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig15 DPE (sciencedirect.com)].
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	*[http://www.glowm.com/resources/glowm/uploads/1225247516_03-50291-007_small.jpg DPE (glowm.com)].<ref name=glowm>URL: [http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235 http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235]. Accessed on: 11 December 2012.</ref>		*[http://www.glowm.com/resources/glowm/uploads/1225247516_03-50291-007_small.jpg DPE (glowm.com)].<ref name=glowm>URL: [http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235 http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235]. Accessed on: 11 December 2012.</ref>
	*[http://www.hsc.stonybrook.edu/gyn-atlas/UT3431B.htm DPE (stonybrook.edu)].		*[http://www.hsc.stonybrook.edu/gyn-atlas/UT3431B.htm DPE (stonybrook.edu)].
	~~<gallery>~~
	~~Image:Endometrial_stromal_condensation_high_mag.jpg \| Endometrial stromal condensation - high mag. (WC/Nephron)~~
	~~</gallery>~~

	==Sign out==		==Sign out==

Michael: /* See also */

2014-05-01T01:15:02Z

Michael at 01:13, 1 May 2014

2014-05-01T01:13:50Z

← Older revision		Revision as of 01:13, 1 May 2014
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	Treatment:		Treatment:
	*Progesterone<ref name=pmid16873562/> versus observation.<ref name=pmid17090792>{{Cite journal \| last1 = Ely \| first1 = JW. \| last2 = Kennedy \| first2 = CM. \| last3 = Clark \| first3 = EC. \| last4 = Bowdler \| first4 = NC. \| title = Abnormal uterine bleeding: a management algorithm. \| journal = J Am Board Fam Med \| volume = 19 \| issue = 6 \| pages = 590-602 \| month = \| year = \| doi = \| PMID = 17090792 \| url = http://www.jabfm.org/content/19/6/590.full }}</ref>		*Progesterone<ref name=pmid16873562>{{Cite journal \| last1 = McCluggage \| first1 = WG. \| title = My approach to the interpretation of endometrial biopsies and curettings. \| journal = J Clin Pathol \| volume = 59 \| issue = 8 \| pages = 801-12 \| month = Aug \| year = 2006 \| doi = 10.1136/jcp.2005.029702 \| PMID = 16873562 }}</ref> versus observation.<ref name=pmid17090792>{{Cite journal \| last1 = Ely \| first1 = JW. \| last2 = Kennedy \| first2 = CM. \| last3 = Clark \| first3 = EC. \| last4 = Bowdler \| first4 = NC. \| title = Abnormal uterine bleeding: a management algorithm. \| journal = J Am Board Fam Med \| volume = 19 \| issue = 6 \| pages = 590-602 \| month = \| year = \| doi = \| PMID = 17090792 \| url = http://www.jabfm.org/content/19/6/590.full }}</ref>

	Image:		Image:

Michael: split out

2014-05-01T01:12:32Z

split out

← Older revision		Revision as of 01:12, 1 May 2014
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	~~#redirect~~ [[~~Endometrium#Disordered_proliferative_endometrium~~]]		'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium\|endometrial]] finding with some features of [[simple endometrial hyperplasia]].

			==General==
			*Association: anovulation.
			*Benign - can be grouped with ''normal''.<ref name=pmid18580308>{{Cite journal \| last1 = Sherman \| first1 = ME. \| last2 = Ronnett \| first2 = BM. \| last3 = Ioffe \| first3 = OB. \| last4 = Richesson \| first4 = DA. \| last5 = Rush \| first5 = BB. \| last6 = Glass \| first6 = AG. \| last7 = Chatterjee \| first7 = N. \| last8 = Duggan \| first8 = MA. \| last9 = Lacey \| first9 = JV. \| title = Reproducibility of biopsy diagnoses of endometrial hyperplasia: evidence supporting a simplified classification. \| journal = Int J Gynecol Pathol \| volume = 27 \| issue = 3 \| pages = 318-25 \| month = Jul \| year = 2008 \| doi = 10.1097/PGP.0b013e3181659167 \| PMID = 18580308 }}</ref>

			Treatment:
			*Progesterone<ref name=pmid16873562/> versus observation.<ref name=pmid17090792>{{Cite journal \| last1 = Ely \| first1 = JW. \| last2 = Kennedy \| first2 = CM. \| last3 = Clark \| first3 = EC. \| last4 = Bowdler \| first4 = NC. \| title = Abnormal uterine bleeding: a management algorithm. \| journal = J Am Board Fam Med \| volume = 19 \| issue = 6 \| pages = 590-602 \| month = \| year = \| doi = \| PMID = 17090792 \| url = http://www.jabfm.org/content/19/6/590.full }}</ref>

			Image:
			*[http://www.jabfm.org/content/19/6/590/F8.expansion.html Treatment algorithim based on endometrial biopsy results (jabfm.org)].<ref name=pmid17090792/>

			==Microscopic==
			Features:<ref name=Ref_PBoD1080>{{Ref PBoD\|1080 and 1082}}</ref>
			*Proliferative type endometrium with:
			**Cystic dilation of glands focally that do not have (glandular) secretions - '''key feature'''.
			***Glands >2x normal size - usually 3-4x normal.
			***Irregular shape, e.g. gland contour has inflection points.
			***Greater than fours glands involved (dilated).
			*+/-Stromal condensation -- balls of stromal tissue, aka "blue balls" (due to breakdown of endometrium).

			Notes:
			*Dilated glands often have tubal metaplasia.{{fact}}
			*Eosinophilic syncytial metaplasia - common.
			**Features: abundant eosinophilic cytoplasm, mild nuclear atypia +/-loss of nuclear stratification, no mitoses).

			DDx:
			*[[Proliferative phase endometrium]].
			**Glands: straight, tubular, tall pseudostratified columnar cells, mitotic figures, no vacuolation, no mucus secretion, abundant mitoses.
			**Stroma: cellular, stroma (spindle cells), mitoses.
			*[[Simple endometrial hyperplasia]] without atypia - architectural atypia diffuse.
			*[[Benign endometrial polyp]].

			===Images===
			www:
			*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig15 DPE (sciencedirect.com)].
			*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig18 DPE (sciencedirect.com)].
			*[http://www.glowm.com/resources/glowm/uploads/1225247516_03-50291-007_small.jpg DPE (glowm.com)].<ref name=glowm>URL: [http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235 http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235]. Accessed on: 11 December 2012.</ref>
			*[http://www.hsc.stonybrook.edu/gyn-atlas/UT3431B.htm DPE (stonybrook.edu)].
			<gallery>
			Image:Endometrial_stromal_condensation_high_mag.jpg \| Endometrial stromal condensation - high mag. (WC/Nephron)
			</gallery>

			==Sign out==
			<pre>
			ENDOMETRIUM, BIOPSY:
			- DISORDERED PROLIFERATIVE ENDOMETRIUM.
			</pre>

			====With endocervix====
			<pre>
			ENDOMETRIUM, BIOPSY:
			- DISORDERED PROLIFERATIVE ENDOMETRIUM.
			- BENIGN ENDOCERVICAL MUCOSA.
			</pre>

			====Waffle a bit====
			<pre>
			ENDOMETRIUM, BIOPSY:
			- COMPATIBLE WITH DISORDERED PROLIFERATIVE ENDOMETRIUM (FRAGMENTS OF PROLIFERATIVE
			ENDOMETRIUM WITH EVIDENCE OF SHEDDING AND VERY RARE GLAND DILATION).
			- VERY SCANT STRIPPED ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY.
			- NEGATIVE FOR ENDOMETRIAL HYPERPLASIA.
			- NEGATIVE FOR MALIGNANCY.
			</pre>

			<pre>
			ENDOMETRIUM, CURETTAGE:
			- PROLIFERATIVE ENDOMETRIUM, FOCALLY WITH GLAND DILATION AND SMALL BLOOD
			VESSELS, SEE COMMENT.
			- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

			COMMENT:
			A fibrotic stroma is not present. The findings may represent a remnant of the previously
			excised endometrial polyp or disordered proliferative endometrium. Follow-up is suggested.
			</pre>

			===Micro===
			The sections show a well-sampled endometrium. Mitotic figures are identified within the
			glands and stroma. Irregular, moderately enlarged glands are seen (only) in one of several
			fragments; most of the endometrial glands are round, regular and small.

			No stromal condensation is apparent. No secretions are in the glands.

			There are no back-to-back glands. No nuclear atypia is apparent. No thick-walled blood
			vessels are apparent.

			==See also==
			*[[Endometrium]].

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

			[[Category:Endometrium]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: redirect

2012-10-01T11:23:08Z

redirect

New page

#redirect [[Endometrium#Disordered_proliferative_endometrium]]

[[Category:Diagnosis]]

← Older revision		Revision as of 01:15, 1 May 2014
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	==See also==		==See also==
	*[[Endometrium]].		*[[Endometrium]].
			*[[Simple endometrial hyperplasia]].
			*[[Waffle diagnosis]].

	==References==		==References==