Difference between revisions of "Disordered proliferative endometrium"

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Disordered proliferative endometrium (view source)

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Disordered proliferative endometrium -- low mag.jpg
| Width      =
| Caption    = Disordered proliferative endometrium. [[H&E stain]].
| Synonyms  =
| Micro      = proliferative endometrial glands (pseudostratified nuclei + mitoses) with focally abnormal glands (glands >2x normal size; irregular shape -- typically with inflection points; >4 glands involved (dilated)), +/-stromal condensation, gland-to-stromal ratio normal, not within an endometrial polyp
| Subtypes  =
| LMDDx      = [[proliferative phase endometrium]],[[simple endometrial hyperplasia]], [[benign endometrial polyp]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[endometrium]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        = followup - re-biopsy
}}
'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium|endometrial]] finding with some features of [[simple endometrial hyperplasia]].
'''Disordered proliferative endometrium''', abbreviated '''DPE''', is an abnormal [[endometrium|endometrial]] finding with some features of [[simple endometrial hyperplasia]].


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Treatment:
Treatment:
*Progesterone<ref name=pmid16873562/> versus observation.<ref name=pmid17090792>{{Cite journal  | last1 = Ely | first1 = JW. | last2 = Kennedy | first2 = CM. | last3 = Clark | first3 = EC. | last4 = Bowdler | first4 = NC. | title = Abnormal uterine bleeding: a management algorithm. | journal = J Am Board Fam Med | volume = 19 | issue = 6 | pages = 590-602 | month =  | year =  | doi =  | PMID = 17090792 | url = http://www.jabfm.org/content/19/6/590.full }}</ref>
*Progesterone<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 }}</ref> versus observation.<ref name=pmid17090792>{{Cite journal  | last1 = Ely | first1 = JW. | last2 = Kennedy | first2 = CM. | last3 = Clark | first3 = EC. | last4 = Bowdler | first4 = NC. | title = Abnormal uterine bleeding: a management algorithm. | journal = J Am Board Fam Med | volume = 19 | issue = 6 | pages = 590-602 | month =  | year =  | doi =  | PMID = 17090792 | url = http://www.jabfm.org/content/19/6/590.full }}</ref>


Image:
Image:
*[http://www.jabfm.org/content/19/6/590/F8.expansion.html Treatment algorithim based on endometrial biopsy results (jabfm.org)].<ref name=pmid17090792/>
*[http://www.jabfm.org/content/19/6/590/F8.expansion.html Treatment algorithm based on endometrial biopsy results (jabfm.org)].<ref name=pmid17090792/>


==Microscopic==
==Microscopic==
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***Glands >2x normal size - usually 3-4x normal.
***Glands >2x normal size - usually 3-4x normal.
***Irregular shape, e.g. gland contour has inflection points.
***Irregular shape, e.g. gland contour has inflection points.
***Greater than fours glands involved (dilated).
***Greater than four glands involved (dilated).
*+/-Stromal condensation -- balls of stromal tissue, aka "blue balls" (due to breakdown of endometrium).
*+/-Stromal condensation -- balls of stromal tissue, aka "blue balls" (due to breakdown of endometrium).


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**Stroma: cellular, stroma (spindle cells), mitoses.
**Stroma: cellular, stroma (spindle cells), mitoses.
*[[Simple endometrial hyperplasia]] without atypia - architectural atypia diffuse.
*[[Simple endometrial hyperplasia]] without atypia - architectural atypia diffuse.
*[[Benign endometrial polyp]].
*[[Benign endometrial polyp]] - may have gland dilation.
*[[Anovulatory endometrium]] - some consider this a synonym, see ''[[relation to disordered proliferative endometrium]]''.


===Images===
===Images===
<gallery>
Image: Disordered proliferative endometrium -- low mag.jpg | DPE - low mag.
Image: Disordered proliferative endometrium -- intermed mag.jpg | DPE - intermed. mag.
Image: Disordered proliferative endometrium - alt -- intermed mag.jpg | DPE - intermed. mag.
Image: Disordered proliferative endometrium -- high mag.jpg | DPE - high mag.
Image: Disordered proliferative endometrium - alt -- high mag.jpg | DPE - high mag.
</gallery>
<gallery>
Image:Endometrial_stromal_condensation_high_mag.jpg | Endometrial stromal condensation - high mag. (WC/Nephron)
</gallery>
www:
www:
*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig15 DPE (sciencedirect.com)].
*[http://www.sciencedirect.com/science/article/pii/S0740257010000997#fig15 DPE (sciencedirect.com)].
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*[http://www.glowm.com/resources/glowm/uploads/1225247516_03-50291-007_small.jpg DPE (glowm.com)].<ref name=glowm>URL: [http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235 http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235]. Accessed on: 11 December 2012.</ref>
*[http://www.glowm.com/resources/glowm/uploads/1225247516_03-50291-007_small.jpg DPE (glowm.com)].<ref name=glowm>URL: [http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235 http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=235]. Accessed on: 11 December 2012.</ref>
*[http://www.hsc.stonybrook.edu/gyn-atlas/UT3431B.htm DPE (stonybrook.edu)].
*[http://www.hsc.stonybrook.edu/gyn-atlas/UT3431B.htm DPE (stonybrook.edu)].
<gallery>
Image:Endometrial_stromal_condensation_high_mag.jpg | Endometrial stromal condensation - high mag. (WC/Nephron)
</gallery>


==Sign out==
==Sign out==
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==See also==
==See also==
*[[Endometrium]].
*[[Endometrium]].
*[[Simple endometrial hyperplasia]].
*[[Waffle diagnosis]].


==References==
==References==
Alessandro
14

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