Difference between revisions of "Anovulatory endometrium"

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#redirect [[Endometrium#Anovulatory endometrium]]
'''Anovulatory endometrium''' is common perimenopausal finding. It is a diagnosis that is inferred from the clinical context.
 
It may be used as a synonym for ''[[disordered proliferative endometrium]]'' (DPE).
 
[[Libre Pathology]] separates the two. DPE has prominent gland dilation (reminiscent of [[simple endometrial hyperplasia]]) and may not have shedding. AV has shedding without gland dilation.
 
==General==
*Individuals usually perimenopausal.
*May be used as a synonym for ''[[disordered proliferative phase]]''.<ref>URL: [http://www.surgpath4u.com/caseviewer.php?case_no=382 http://www.surgpath4u.com/caseviewer.php?case_no=382]. Accessed on: 9 May 2013.</ref>
 
==Microscopic==
Features:
*Shedding:
**Stromal condensation.
**Apoptotic endometrial epithelium.
*Weakly proliferative glands or non-proliferative glands.
 
DDx:
*[[Disordered proliferative phase]] - gland dilation.
*[[Simple endometrial hyperplasia]].
*[[Menstrual endometrium]] - should have mitoses,<ref name=Ref_DCHH237>{{Ref DCHH|237}}</ref> abundant [[PMN]]s.
 
==Sign out==
<pre>
ENDOMETRIUM, CURETTAGE:
- FRAGMENTED PROLIFERATIVE ENDOMETRIUM WITH EVIDENCE OF SHEDDING, WITHOUT ABUNDANT
  NEUTROPHILS, SEE COMMENT.
- NO EVIDENCE OF HYPERPLASIA.
- NEGATIVE FOR MALIGNANCY.
 
COMMENT:
The changes are compatible with anovulatory bleeding.
</pre>
 
<pre>
ENDOMETRIUM, CURETTAGE:
- PROLIFERATIVE ENDOMETRIUM WITH SMALL ROUND GLANDS AND SHEDDING, SEE COMMENT.
- BENIGN ENDOCERVICAL MUCOSA.
- NEGATIVE FOR HYPERPLASIA.
- NEGATIVE FOR MALIGNANCY.
 
COMMENT:
The changes are suggestive of anovulatory bleeding.
</pre>
 
<pre>
ENDOMETRIUM, BIOPSY:
- BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION, AND EVIDENCE
  SUGGESTIVE OF EROSIONS (SIDEROPHAGES, INCREASED BLOOD VESSEL DENSITY).
- SMALL NONPROLIFERATIVE ENDOMETRIAL GLANDS WITH RARE NEUTROPHILS AND RARE
  APOPTOTIC CELLS, WITH BALLS OF CONDENSED ENDOMETRIAL STROMA, SEE COMMENT.
- NEGATIVE FOR ENDOMETRIAL HYPERPLASIA AND NEGATIVE FOR DYSPLASIA.
 
COMMENT:
The changes are suggestive of anovulatory bleeding.
</pre>
 
<pre>
ENDOMETRIUM, ASPIRATION:
- PSEUDOSTRATIFIED ENDOMETRIAL EPITHELIUM WITHOUT APPARENT PROLIFERATION, WITH
  APOPTOTIC CELLS AND LIMITED STROMA WITH RARE (STROMAL) CONDENSATION -- COMPATIBLE
  WITH SHEDDING.
- MINUTE FRAGMENTS OF BENIGN ENDOCERVICAL EPITHELIUM.
- NO EVIDENCE OF HYPERPLASIA.
</pre>
 
==See also==
*[[Endometrium]].
*[[Disordered proliferative endometrium]].
 
==References==
{{Reflist|2}}
 
[[Category:Endometrium]]

Revision as of 12:13, 18 June 2014

Anovulatory endometrium is common perimenopausal finding. It is a diagnosis that is inferred from the clinical context.

It may be used as a synonym for disordered proliferative endometrium (DPE).

Libre Pathology separates the two. DPE has prominent gland dilation (reminiscent of simple endometrial hyperplasia) and may not have shedding. AV has shedding without gland dilation.

General

Microscopic

Features:

  • Shedding:
    • Stromal condensation.
    • Apoptotic endometrial epithelium.
  • Weakly proliferative glands or non-proliferative glands.

DDx:

Sign out

ENDOMETRIUM, CURETTAGE:
- FRAGMENTED PROLIFERATIVE ENDOMETRIUM WITH EVIDENCE OF SHEDDING, WITHOUT ABUNDANT
  NEUTROPHILS, SEE COMMENT.
- NO EVIDENCE OF HYPERPLASIA.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
The changes are compatible with anovulatory bleeding.

ENDOMETRIUM, CURETTAGE:
- PROLIFERATIVE ENDOMETRIUM WITH SMALL ROUND GLANDS AND SHEDDING, SEE COMMENT.
- BENIGN ENDOCERVICAL MUCOSA.
- NEGATIVE FOR HYPERPLASIA.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
The changes are suggestive of anovulatory bleeding.

ENDOMETRIUM, BIOPSY:
- BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION, AND EVIDENCE
  SUGGESTIVE OF EROSIONS (SIDEROPHAGES, INCREASED BLOOD VESSEL DENSITY).
- SMALL NONPROLIFERATIVE ENDOMETRIAL GLANDS WITH RARE NEUTROPHILS AND RARE
  APOPTOTIC CELLS, WITH BALLS OF CONDENSED ENDOMETRIAL STROMA, SEE COMMENT.
- NEGATIVE FOR ENDOMETRIAL HYPERPLASIA AND NEGATIVE FOR DYSPLASIA.

COMMENT:
The changes are suggestive of anovulatory bleeding.

ENDOMETRIUM, ASPIRATION:
- PSEUDOSTRATIFIED ENDOMETRIAL EPITHELIUM WITHOUT APPARENT PROLIFERATION, WITH
  APOPTOTIC CELLS AND LIMITED STROMA WITH RARE (STROMAL) CONDENSATION -- COMPATIBLE
  WITH SHEDDING.
- MINUTE FRAGMENTS OF BENIGN ENDOCERVICAL EPITHELIUM.
- NO EVIDENCE OF HYPERPLASIA.

See also

References

  1. ↑ URL: http://www.surgpath4u.com/caseviewer.php?case_no=382. Accessed on: 9 May 2013.
  2. ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 237. ISBN 978-0470519035.
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