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Difference between revisions of "Endometrium with squamous morules"
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Endometrium with squamous morules (view source)
Revision as of 12:35, 18 June 2014
, 12:35, 18 June 2014→See also
| (10 intermediate revisions by the same user not shown) | |||
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| Micro = well-circumscribed ball of squamoid cells -- cells have a whorled arrangement, moderate eosinophilic cytoplasm and a bland nucleus | | Micro = well-circumscribed ball of squamoid cells -- cells have a whorled arrangement, moderate eosinophilic cytoplasm and a bland nucleus | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[endometrial hyperplasia]], [[endometrial carcinoma]] - esp. [[endometrioid endometrial carcinoma]], [[uterine leiomyoma]] | | LMDDx = [[endometrial hyperplasia]], [[endometrial carcinoma]] - esp. [[endometrioid endometrial carcinoma]], [[uterine leiomyoma]], [[atypical polypoid adenomyoma]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
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| ClinDDx = | | ClinDDx = | ||
}} | }} | ||
:''Squamous morules'' redirects here. | |||
'''Endometrium with squamous morules''' is important to recognize as squamous morules are strongly associated with [[malignancy]]. | '''Endometrium with squamous morules''' is important to recognize as squamous morules are strongly associated with [[malignancy]]. | ||
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*Benign finding in itself. | *Benign finding in itself. | ||
*Strong association with malignancy.<ref name=pmid21126963>{{Cite journal | last1 = Nicolae | first1 = A. | last2 = Preda | first2 = O. | last3 = Nogales | first3 = FF. | title = Endometrial metaplasias and reactive changes: a spectrum of altered differentiation. | journal = J Clin Pathol | volume = 64 | issue = 2 | pages = 97-106 | month = Feb | year = 2011 | doi = 10.1136/jcp.2010.085555 | PMID = 21126963 }}</ref> | *Strong association with malignancy.<ref name=pmid21126963>{{Cite journal | last1 = Nicolae | first1 = A. | last2 = Preda | first2 = O. | last3 = Nogales | first3 = FF. | title = Endometrial metaplasias and reactive changes: a spectrum of altered differentiation. | journal = J Clin Pathol | volume = 64 | issue = 2 | pages = 97-106 | month = Feb | year = 2011 | doi = 10.1136/jcp.2010.085555 | PMID = 21126963 }}</ref> | ||
**Associated with glandular lesions, i.e. endometrial hyperplasia and adenocarcinoma, ''not'' neoplastic squamous lesions.<ref>{{Cite journal | last1 = Lin | first1 = MC. | last2 = Lomo | first2 = L. | last3 = Baak | first3 = JP. | last4 = Eng | first4 = C. | last5 = Ince | first5 = TA. | last6 = Crum | first6 = CP. | last7 = Mutter | first7 = GL. | title = Squamous morules are functionally inert elements of premalignant endometrial neoplasia. | journal = Mod Pathol | volume = 22 | issue = 2 | pages = 167-74 | month = Feb | year = 2009 | doi = 10.1038/modpathol.2008.146 | PMID = 19180120 }}</ref> | **Associated with glandular lesions, i.e. endometrial hyperplasia and adenocarcinoma, ''not'' neoplastic squamous lesions.<ref name=pmid19180120>{{Cite journal | last1 = Lin | first1 = MC. | last2 = Lomo | first2 = L. | last3 = Baak | first3 = JP. | last4 = Eng | first4 = C. | last5 = Ince | first5 = TA. | last6 = Crum | first6 = CP. | last7 = Mutter | first7 = GL. | title = Squamous morules are functionally inert elements of premalignant endometrial neoplasia. | journal = Mod Pathol | volume = 22 | issue = 2 | pages = 167-74 | month = Feb | year = 2009 | doi = 10.1038/modpathol.2008.146 | PMID = 19180120 }}</ref> | ||
==Microscopic== | ==Microscopic== | ||
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*[[Endometrioid endometrial carcinoma]]. | *[[Endometrioid endometrial carcinoma]]. | ||
*[[Uterine leiomyoma]]. | *[[Uterine leiomyoma]]. | ||
*[[Atypical polypoid adenomyoma]] - squamous morules ''and'' proliferation of smooth muscle. | |||
===Images=== | ===Images=== | ||
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Image: Squamous morule 2 - endometrium -- extremely high mag.jpg | SM - extremely high mag. | Image: Squamous morule 2 - endometrium -- extremely high mag.jpg | SM - extremely high mag. | ||
</gallery> | </gallery> | ||
www: | |||
*[http://www.nature.com/modpathol/journal/v22/n2/fig_tab/modpathol2008146f1.html Squamous morules - several (nature.com)]. | |||
*[http://www.nature.com/modpathol/journal/v22/n2/fig_tab/modpathol2008146f2.html Squamous morule and IHC stains (nature.com)].<ref name=pmid19180120>{{Cite journal | last1 = Lin | first1 = MC. | last2 = Lomo | first2 = L. | last3 = Baak | first3 = JP. | last4 = Eng | first4 = C. | last5 = Ince | first5 = TA. | last6 = Crum | first6 = CP. | last7 = Mutter | first7 = GL. | title = Squamous morules are functionally inert elements of premalignant endometrial neoplasia. | journal = Mod Pathol | volume = 22 | issue = 2 | pages = 167-74 | month = Feb | year = 2009 | doi = 10.1038/modpathol.2008.146 | PMID = 19180120 }}</ref> | |||
==IHC== | |||
Features:<ref name=pmid19180120>{{Cite journal | last1 = Lin | first1 = MC. | last2 = Lomo | first2 = L. | last3 = Baak | first3 = JP. | last4 = Eng | first4 = C. | last5 = Ince | first5 = TA. | last6 = Crum | first6 = CP. | last7 = Mutter | first7 = GL. | title = Squamous morules are functionally inert elements of premalignant endometrial neoplasia. | journal = Mod Pathol | volume = 22 | issue = 2 | pages = 167-74 | month = Feb | year = 2009 | doi = 10.1038/modpathol.2008.146 | PMID = 19180120 }}</ref> | |||
*ER -ve. | |||
*PR -ve. | |||
*Ki-67 low. | |||
==Sign out== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- PROLIFERATIVE PHASE ENDOMETRIUM WITH A FOCUS OF SQUAMOUS MORULES, SEE COMMENT. | |||
COMMENT: | |||
There is no evidence of hyperplasia or malignancy in this biopsy; however, squamous morules | |||
are associated with hyperplasia and malignancy. Close follow-up and a re-biopsy (when | |||
clinically indicated) are recommended. | |||
</pre> | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- EXTENSIVELY FRAGMENTED ENDOMETRIUM WITH ABUNDANT SQUAMOUS MORULES, SEE COMMENT. | |||
- FOCAL STROMAL CONDENSATION SUGGESTIVE OF SHEDDING. | |||
COMMENT: | |||
The fragmentation makes it difficult to assess for hyperplasia. The squamous morules have | |||
degenerative changes centrally. There is no evidence of malignancy in this biopsy. | |||
Squamous morules are associated with hyperplasia and malignancy. Close follow-up and a | |||
re-biopsy (when clinically indicated) are recommended. | |||
</pre> | |||
==See also== | ==See also== | ||
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*[[Endometrial hyperplasia]]. | *[[Endometrial hyperplasia]]. | ||
*[[Metaplasias of the endometrium]]. | *[[Metaplasias of the endometrium]]. | ||
*[[Endometrium with psammoma bodies]]. | |||
==References== | ==References== | ||