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Proliferative phase endometrium (view source)
Revision as of 20:09, 7 January 2019
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**"Exodus" pattern is a term used to describe exfoliation of endometrial cells during the proliferative phase. | **"Exodus" pattern is a term used to describe exfoliation of endometrial cells during the proliferative phase. | ||
***On [[pap test]]s this is associated with the classic double contoured balls of endometrial epithelium and stroma. | ***On [[pap test]]s this is associated with the classic double contoured balls of endometrial epithelium and stroma. | ||
*Proliferative activity is relatively common in postmenopausal women ~25% and probably associated with a small increased risk of malignancy.<ref name=pmid15280405>{{Cite journal | last1 = Sivridis | first1 = E. | last2 = Giatromanolaki | first2 = A. | title = Proliferative activity in postmenopausal endometrium: the lurking potential for giving rise to an endometrial adenocarcinoma. | journal = J Clin Pathol | volume = 57 | issue = 8 | pages = 840-4 | month = Aug | year = 2004 | doi = 10.1136/jcp.2003.014399 | PMID = 15280405 }}</ref> | |||
**~17% of asymptomatic (unselected) postmenopausal women have proliferative endometrium.<ref name=pmid1872332>{{Cite journal | last1 = Archer | first1 = DF. | last2 = McIntyre-Seltman | first2 = K. | last3 = Wilborn | first3 = WW. | last4 = Dowling | first4 = EA. | last5 = Cone | first5 = F. | last6 = Creasy | first6 = GW. | last7 = Kafrissen | first7 = ME. | title = Endometrial morphology in asymptomatic postmenopausal women. | journal = Am J Obstet Gynecol | volume = 165 | issue = 2 | pages = 317-20; discussion 320-2 | month = Aug | year = 1991 | doi = | PMID = 1872332 }}</ref> | |||
Note: | Note: | ||
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Notes: | Notes: | ||
* † McCluggage says one shouldn't call ''PPE'' without mitoses, as some pseudostratification can be seen in [[atrophic endometrium]].<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 | PMC = 1860448 }}</ref> | * † McCluggage says one shouldn't call ''PPE'' without mitoses, as some pseudostratification can be seen in [[atrophic endometrium]].<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 | PMC = 1860448 }}</ref> | ||
** There is no guidance on how hard one should look. | ** There is no guidance on how hard one should look. Perhaps ~ 10 mm<sup>2</sup> with the 20x objective? Ten millimetres squared represents approximately ~ 10 fields of view with a microscope that has a 22 mm eye piece. | ||
* Significant negatives: | * Significant negatives: | ||
** No vacuolation. | ** No vacuolation. | ||
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===Images=== | ===Images=== | ||
====Case 1==== | |||
<gallery> | <gallery> | ||
Image: Proliferative phase endometrium -- very low mag.jpg | PPE - very low mag. (WC) | Image: Proliferative phase endometrium -- very low mag.jpg | PPE - very low mag. (WC) | ||
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Image: Proliferative phase endometrium -- high mag.jpg | PPE - high mag. (WC) | Image: Proliferative phase endometrium -- high mag.jpg | PPE - high mag. (WC) | ||
</gallery> | </gallery> | ||
====Case 2==== | |||
<gallery> | <gallery> | ||
Image:Endometrial epithelium with proliferation - intermed mag.jpg | Proliferative endometrial epithelium - intermed. mag. (WC) | Image:Endometrial epithelium with proliferation - intermed mag.jpg | Proliferative endometrial epithelium - intermed. mag. (WC) | ||
Image:Endometrial epithelium with proliferation - high mag.jpg | Proliferative endometrial epithelium - high mag. (WC) | Image:Endometrial epithelium with proliferation - high mag.jpg | Proliferative endometrial epithelium - high mag. (WC) | ||
</gallery> | </gallery> | ||
www | ====Case 3==== | ||
<gallery> | |||
Image: Coiled endometrium -- low mag.jpg | [[Coiled endometrium|Coiled proliferative endometrium]] - low mag. (WC) | |||
Image: Coiled endometrium -- intermed mag.jpg | Coiled proliferative endometrium - intermed. mag. (WC) | |||
Image: Coiled endometrium - alt -- intermed mag.jpg | Coiled proliferative endometrium - intermed. mag. (WC) | |||
Image: Coiled endometrium -- high mag.jpg | Coiled proliferative endometrium - intermed. mag. (WC) | |||
</gallery> | |||
====www==== | |||
*[http://library.med.utah.edu/WebPath/FEMHTML/FEM017.html Proliferative phase endometrium (utah.edu)]. | *[http://library.med.utah.edu/WebPath/FEMHTML/FEM017.html Proliferative phase endometrium (utah.edu)]. | ||
*[http://www.cytochemistry.net/microanatomy/medical_lectures/028%20-%2019_16f.jpg Proliferative phase endometrium (cytochemistry.net)].<ref>URL: [http://www.cytochemistry.net/microanatomy/medical_lectures/oviduct_and_uterus.htm http://www.cytochemistry.net/microanatomy/medical_lectures/oviduct_and_uterus.htm]. Accessed on: 23 October 2012.</ref> | *[http://www.cytochemistry.net/microanatomy/medical_lectures/028%20-%2019_16f.jpg Proliferative phase endometrium (cytochemistry.net)].<ref>URL: [http://www.cytochemistry.net/microanatomy/medical_lectures/oviduct_and_uterus.htm http://www.cytochemistry.net/microanatomy/medical_lectures/oviduct_and_uterus.htm]. Accessed on: 23 October 2012.</ref> | ||
==Sign out== | ==Sign out== | ||
<pre> | |||
Endometrium, Curettage: | |||
- Proliferative endometrium. | |||
- Scant benign endocervical mucosa present. | |||
- NEGATIVE for hyperplasia and NEGATIVE for malignancy. | |||
</pre> | |||
<pre> | <pre> | ||
ENDOMETRIUM, BIOPSY: | ENDOMETRIUM, BIOPSY: | ||
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- PROLIFERATIVE-TYPE ENDOMETRIUM, LIMITED STROMA PRESENT. | - PROLIFERATIVE-TYPE ENDOMETRIUM, LIMITED STROMA PRESENT. | ||
- STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS. | - STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS. | ||
- NO EVIDENCE OF HYPERPLASIA. | |||
</pre> | |||
====Mostly atrophic==== | |||
<pre> | |||
ENDOMETRIUM, ASPIRATION: | |||
- FRAGMENTS OF PREDOMINANT INACTIVE, VERY WEAKLY PROLIFERATIVE ENDOMETRIAL EPITHELIUM | |||
ATTACHED TO A VERY SMALL AMOUNT OF UNREMARKABLE STROMA. | |||
- AMOUNT OF STROMA NOT SUFFICIENT TO ASSESS GLAND-TO-STROMA RATIO. | |||
- NO EVIDENCE OF HYPERPLASIA. | - NO EVIDENCE OF HYPERPLASIA. | ||
</pre> | </pre> | ||