Difference between revisions of "Endometrial carcinoma"

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(re-work, subdivide)
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An introduction to the endometrium is in the article ''[[endometrium]]''.
An introduction to the endometrium is in the article ''[[endometrium]]''.


==Clinical==
=Clinical=
===Risk factors===
===Risk factors===
Risk factors for endometrial carcinoma - mnemonic ''COLD NUT'':<ref>TN07 GY40</ref>
Risk factors for endometrial carcinoma - mnemonic ''COLD NUT'':<ref>TN07 GY40</ref>
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*Non-endometrioid ''or'' high stage endometrioid ''or'' high-grade endometrioid: ''radical hysterectomy'' (includes cervix, vaginal cuff, parametrial tissue).
*Non-endometrioid ''or'' high stage endometrioid ''or'' high-grade endometrioid: ''radical hysterectomy'' (includes cervix, vaginal cuff, parametrial tissue).


==Subtypes==
==Subtypes - overview==
They are commonly grouped based on clinicopathologic features:<ref name=pmid21309259>{{Cite journal  | last1 = Lim | first1 = D. | last2 = Oliva | first2 = E. | title = Nonendometrioid endometrial carcinomas. | journal = Semin Diagn Pathol | volume = 27 | issue = 4 | pages = 241-60 | month = Nov | year = 2010 | doi =  | PMID = 21309259 }}</ref>
They are commonly grouped based on clinicopathologic features:<ref name=pmid21309259>{{Cite journal  | last1 = Lim | first1 = D. | last2 = Oliva | first2 = E. | title = Nonendometrioid endometrial carcinomas. | journal = Semin Diagn Pathol | volume = 27 | issue = 4 | pages = 241-60 | month = Nov | year = 2010 | doi =  | PMID = 21309259 }}</ref>
#Type I:
#Type I:
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#Serous - patients classically older than endometrioid subtype, arise in atrophic endometrium.
#Serous - patients classically older than endometrioid subtype, arise in atrophic endometrium.
#Clear cell.
#Clear cell.
===Microscopic (summary)===
Features in most common subtypes (in short):
*Serous:
**Columnar cells.
**Cilia.
**[[Psammoma bodies]].
**Papillae.
*Endometrioid:
**Tubular glands.
**Squamous metaplasia.
***Look for ''squamous morules'':
****Ball of cells with intensely eosinophilic cytoplasm, dyskeratotic cell(s) - ([http://www.diagnosticpathology.org/content/2/1/40/figure/F1?highres=y image of squamous morule with dyskeratotic cell (diagnosticpathology.org)]).
*Clear cell.
**Classically clear cells... but not always.
**Hobnailing (apical cytoplasm > cytoplasm on basement membrane).
Notes:
*Dyskeratosis = abnormal keratinization;<ref>URL: [http://dictionary.reference.com/browse/dyskeratosis http://dictionary.reference.com/browse/dyskeratosis]. Accessed on: 5 September 2011.</ref> classically have intensely eosinophilic cytoplasm +/- nuclear fragmentation ([http://dictionary.reference.com/browse/karyolysis?db=medical&q=karyolysis karyorrhexis]) - see: [http://www.drmihm.com/pictures/Figure%203.jpg several dyskeratotic cells].


==Grading (FIGO)==
==Grading (FIGO)==
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Ref: <ref>{{Ref PBoD|1088}}</ref>, <ref>[http://www.emedicine.com/med/topic2832.htm http://www.emedicine.com/med/topic2832.htm]</ref>, <ref>[http://www.cancerfacts.com/GeneralContent/Uterine/Gen_Diagnosis.asp?CB=11 Staging with groovy graphics (cancerfacts.com)]</ref>
Ref: <ref>{{Ref PBoD|1088}}</ref>, <ref>[http://www.emedicine.com/med/topic2832.htm http://www.emedicine.com/med/topic2832.htm]</ref>, <ref>[http://www.cancerfacts.com/GeneralContent/Uterine/Gen_Diagnosis.asp?CB=11 Staging with groovy graphics (cancerfacts.com)]</ref>


==See also==
=Specific types=
==Endometrioid endometrial carcinoma==
===Microscopic===
Features - endometrioid:
*Tubular glands.
*Squamous metaplasia.
**Look for ''squamous morules'':
**Ball of cells with intensely eosinophilic cytoplasm, dyskeratotic cell(s) - ([http://www.diagnosticpathology.org/content/2/1/40/figure/F1?highres=y image of squamous morule with dyskeratotic cell (diagnosticpathology.org)]).
 
Notes:
*Dyskeratosis = abnormal keratinization;<ref>URL: [http://dictionary.reference.com/browse/dyskeratosis http://dictionary.reference.com/browse/dyskeratosis]. Accessed on: 5 September 2011.</ref> classically have intensely eosinophilic cytoplasm +/- nuclear fragmentation ([http://dictionary.reference.com/browse/karyolysis?db=medical&q=karyolysis karyorrhexis]) - see: [http://www.drmihm.com/pictures/Figure%203.jpg several dyskeratotic cells].
 
==Serous endometrial carcinoma==
===Microscopic===
Features - serous:
*Serous:
**Columnar cells.
**Cilia.
**[[Psammoma bodies]].
**Papillae.
 
==Clear cell endometrial carcinoma==
===Microscopic===
Features - clear cell:
**Classically clear cells... but not always.
**Hobnailing (apical cytoplasm > cytoplasm on basement membrane).
 
=See also=
*[[Endometrium]].
*[[Endometrium]].
*[[Uterine tumours]] - other uterine tumours, e.g. carcinosarcoma, endometrial stromal sarcoma.
*[[Uterine tumours]] - other uterine tumours, e.g. carcinosarcoma, endometrial stromal sarcoma.
*[[Gynecologic pathology]] - overview.
*[[Gynecologic pathology]] - overview.


==References==
=References=
{{reflist|2}}
{{reflist|2}}


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