Difference between revisions of "Endometrium with changes due to exogenous hormones"

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Endometrium with changes due to exogenous hormones
Diagnosis in short

Endometrium with hormonal changes due to the OCP. H&E stain.

LM inactive glands (round/ovoid glands, simple cuboidal epithelium, no mitoses), decidualized stroma (nucleus central, eosinophilic cytoplasm, well-defined cell borders)
LM DDx endometrial hyperplasia with secretory changes, secretory phase endometrium
Site endometrium

Clinical history exogenous hormones (oral contraceptive pill or hormone releasing intrauterine device)
Prognosis benign
Endometrium with changes due to exogenous hormones
External resources
EHVSC 10170

Endometrium with hormonal changes is relatively common in endometrial samples.

Endometrial changes of oral contraception, oral contraceptive effect and OCP endometrium redirect here.

The oral contraceptive pill is dealt with in the article oral contraceptive pill.

General

  • Very common.
  • Most pills a mix of progesterone and estrogen.
    • The progesterone is what generates the characteristic appearance -- that is similar to pregnancy.

Microscopic

Features:[1]

  • Inactive glands (round/ovoid glands, simple cuboidal epithelium, no mitoses).
  • Stroma decidualized -- mnemonic NEW:
    • Nucleus central.
    • Eosinophilic cytoplasm.
    • Well-defined cell borders.

DDx:

Image

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ENDOMETRIUM, BIOPSY:
- NON-PROLIFERATIVE ENDOMETRIAL GLANDS WITH STROMAL DECIDUALIZATION, CONSISTENT 
  WITH EXOGENOUS HORMONES.

OCP effect and shedding endometrium

ENDOMETRIUM, ASPIRATION:
- ENDOMETRIUM WITH NONPROLIFERATIVE ENDOMETRIAL GLANDS AND
  STROMAL DECIDUALIZATION, COMPATIBLE WITH EXOGENOUS HORMONES.
- EVIDENCE OF ENDOMETRIAL SHEDDING (BALLS OF CONDENSED STROMA
  ASSOCIATED NEUTROPHILS, AND BLOOD).
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

See also

References

  1. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1082. ISBN 0-7216-0187-1.