Difference between revisions of "Endometrioid endometrial carcinoma"

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'''Endometrioid endometrial carcinoma''' is a type of [[endometrial carcinoma]].
'''Endometrioid endometrial carcinoma''' is a type of [[endometrial carcinoma]].


*[[AKA]] ''endometrioid endometrial adenocarcinoma''.
It is also known as '''endometrioid endometrial adenocarcinoma'''.


==General==
==General==
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**Typical patient is [[obese]].
**Typical patient is [[obese]].


===Gross===
==Gross==
*Thickened endometrium.
*Thickened endometrium.


===Microscopic===
==Microscopic==
Features:
Features:
*Atypical (ovoid) glands with - one of the following four:<ref name=Ref_GP239>{{Ref GP|239}}</ref><ref name=pmid7074572>{{Cite journal  | last1 = Kurman | first1 = RJ. | last2 = Norris | first2 = HJ. | title = Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma. | journal = Cancer | volume = 49 | issue = 12 | pages = 2547-59 | month = Jun | year = 1982 | doi =  | PMID = 7074572 }}</ref><ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Endometrium_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Endometrium_11protocol.pdf]. Accessed on: 12 January 2012.</ref>
*Atypical (ovoid) glands with - one of the following four:<ref name=Ref_GP239>{{Ref GP|239}}</ref><ref name=pmid7074572>{{Cite journal  | last1 = Kurman | first1 = RJ. | last2 = Norris | first2 = HJ. | title = Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma. | journal = Cancer | volume = 49 | issue = 12 | pages = 2547-59 | month = Jun | year = 1982 | doi =  | PMID = 7074572 }}</ref><ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Endometrium_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Endometrium_11protocol.pdf]. Accessed on: 12 January 2012.</ref>
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*[[Clear cell carcinoma of the endometrium]] - esp. when clear cells present.
*[[Clear cell carcinoma of the endometrium]] - esp. when clear cells present.


====Images====
===Images===
<gallery>
<gallery>
Image:Endometrioid endometrial adenocarcinoma low mag.jpg | EEA - low mag. (WC)
Image:Endometrioid endometrial adenocarcinoma low mag.jpg | EEA - low mag. (WC)
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*[http://www.diagnosticpathology.org/content/2/1/40/figure/F1?highres=y Squamous morule with dyskeratotic cell (diagnosticpathology.org)].
*[http://www.diagnosticpathology.org/content/2/1/40/figure/F1?highres=y Squamous morule with dyskeratotic cell (diagnosticpathology.org)].


===IHC===
==IHC==
*Vimentin +ve.
*Vimentin +ve.
*ER +ve.
*ER +ve.
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*CEA -ve.
*CEA -ve.


===Sign out===
==Sign out==
<pre>
<pre>
ENDOMETRIUM, BIOPSY:  
ENDOMETRIUM, BIOPSY:  
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</pre>
</pre>


====Micro====
===Micro===
The sections show endometrium with complex, fused and cribriform glands with scant intervening stroma over a region measuring greater than 2.1 millimetres. Focally, a desmoplastic stroma is also identified. No nuclear atypia is appreciated.
The sections show endometrium with complex, fused and cribriform glands with scant intervening stroma over a region measuring greater than 2.1 millimetres. Focally, a desmoplastic stroma is also identified. No nuclear atypia is appreciated.


====Endocervical versus endometrial - biopsy====
===Endocervical versus endometrial - biopsy===
The foamy histiocytes in the stroma and lack of desmoplasia slightly favour an endometrial origin; however, the lesion would be best classified with an excisional specimen and in conjunction with the clinical impression.
The foamy histiocytes in the stroma and lack of desmoplasia slightly favour an endometrial origin; however, the lesion would be best classified with an excisional specimen and in conjunction with the clinical impression.


==See also==
==See also==
*[[Endometrial carcinoma
*[[Endometrial carcinoma]].
 
*[[Endometrial hyperplasia]].


==References==
==References==

Revision as of 03:19, 22 January 2014

Endometrioid endometrial carcinoma is a type of endometrial carcinoma.

It is also known as endometrioid endometrial adenocarcinoma.

General

  • Good prognosis - usually.
  • Women in 40s & 50s.
  • Associated with estrogen excess.
    • Typical patient is obese.

Gross

  • Thickened endometrium.

Microscopic

Features:

  • Atypical (ovoid) glands with - one of the following four:[1][2][3]
    1. Desmoplastic stromal response.
    2. Confluent cribriform growth. †
    3. Extensive papillary growth. †
    4. Severe cytologic atypia. †
  • Squamous metaplasia - very common.
    • Look for squamous morules:
      • Ball of cells with an intensely eosinophilic cytoplasm - key feature.
      • Central nucleus.
      • Intercellular bridges - may be hard to find.
      • +/-Dyskeratotic cells.

Notes:

  • † There is a size cut-off for criteria 2, 3 and 4: > 2.1 mm.[2]
  • Dyskeratosis = abnormal keratinization;[4] classically have intensely eosinophilic cytoplasm +/- nuclear fragmentation (karyorrhexis) - see: several dyskeratotic cells.
  • Squamous metaplasia != neoplastic -- it may occur due to hormones.[5]
  • Squamous morules in endometrioid endometrial carcinoma - not associated with HPV infection.[6]

DDx:

Images

  • EEA - low mag. (WC)

  • EEA - intermed. mag. (WC)

  • EEA - high mag. (WC)

  • EEA - very high mag. (WC)

www:

IHC

  • Vimentin +ve.
  • ER +ve.
  • PR +ve.

Others:

Sign out

ENDOMETRIUM, BIOPSY: 
- ENDOMETRIOID ENDOMETRIAL ADENOCARCINOMA, FIGO GRADE I/III.

Micro

The sections show endometrium with complex, fused and cribriform glands with scant intervening stroma over a region measuring greater than 2.1 millimetres. Focally, a desmoplastic stroma is also identified. No nuclear atypia is appreciated.

Endocervical versus endometrial - biopsy

The foamy histiocytes in the stroma and lack of desmoplasia slightly favour an endometrial origin; however, the lesion would be best classified with an excisional specimen and in conjunction with the clinical impression.

See also

References

  1. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 239. ISBN 978-0443069208.
  2. ↑ 2.0 2.1 Kurman, RJ.; Norris, HJ. (Jun 1982). "Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma.". Cancer 49 (12): 2547-59. PMID 7074572.
  3. ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Endometrium_11protocol.pdf. Accessed on: 12 January 2012.
  4. ↑ URL: http://dictionary.reference.com/browse/dyskeratosis. Accessed on: 5 September 2011.
  5. ↑ Miranda, MC.; Mazur, MT. (May 1995). "Endometrial squamous metaplasia. An unusual response to progestin therapy of hyperplasia.". Arch Pathol Lab Med 119 (5): 458-60. PMID 7748076.
  6. ↑ Chinen, K.; Kamiyama, K.; Kinjo, T.; Arasaki, A.; Ihama, Y.; Hamada, T.; Iwamasa, T. (Sep 2004). "Morules in endometrial carcinoma and benign endometrial lesions differ from squamous differentiation tissue and are not infected with human papillomavirus.". J Clin Pathol 57 (9): 918-26. doi:10.1136/jcp.2004.017996. PMID 15333650.
  7. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named pmid17581420
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