Difference between revisions of "Arias-Stella reaction"

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#redirect [[Products_of_conception#Arias-Stella_reaction]]
The '''Arias-Stella reaction''' is a benign change.
 
==General==
*Benign atypical endometrial changes associated with chorionic tissue.<ref name=pmid11756756>{{Cite journal  | last1 = Arias-Stella | first1 = J. | title = The Arias-Stella reaction: facts and fancies four decades after. | journal = Adv Anat Pathol | volume = 9 | issue = 1 | pages = 12-23 | month = Jan | year = 2002 | doi =  | PMID = 11756756 }}</ref>
**May be seen in a normal pregnancy, [[hydatidiform mole]]s, others.
*Historically it was diagnosed as [[endometrial cancer]].
 
Note:
*To the novice... the nuclei look really scary, i.e. they look like cancer.
 
==Microscopic==
Features:<ref name=pmid11756756/>
*Epithelial component of endometrium with large nuclei - '''key feature'''.
**+/-Nuclear hyperchromasia, i.e. dark nuclei.
**+/-Irregular nuclear membrane.
**+/-Nuclear clearing.<ref name=Ref_DCHH236-7>{{Ref DCHH|236-7}}.</ref>
**+/-[[Nuclear pseudoinclusions]].
*[[NC ratio]] is preserved.<ref name=Ref_DCHH236-7>{{Ref DCHH|236-7}}</ref>
*Usually a focal change.
*+/-Mitoses - uncommon.
 
Notes:
*No decidual reaction in the stroma.
 
DDx:
*[[Choriocarcinoma]].
*[[Herpes simplex virus|Herpetic]] [[endometritis]].
*Clear cell carcinoma.
 
Images:
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_3_-_low_mag.jpg Intermediate trophoblast reaction - low mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_3_-_high_mag.jpg Intermediate trophoblast - high mag. (WC)].
 
===Subtypes===
There are five subtypes:<ref name=pmid11756756/>
#Minimal atypia.
#*Usually early gestation.
#Early secretory pattern.
#*Mimics secretory endometrium: cytoplasmic vacuoles, central nucleus, palisading architecture.
#Secretory or hypersecretory pattern.
#Regenerative, proliferative or nonsecretory pattern.
#Monstrous cell pattern.
 
==See also==
*[[Gynecologic pathology]].
 
==References==
{{Reflist|2}}
 
[[Category:Gynecologic pathology]]

Revision as of 15:26, 19 October 2011

The Arias-Stella reaction is a benign change.

General

Note:

  • To the novice... the nuclei look really scary, i.e. they look like cancer.

Microscopic

Features:[1]

  • Epithelial component of endometrium with large nuclei - key feature.
  • NC ratio is preserved.[2]
  • Usually a focal change.
  • +/-Mitoses - uncommon.

Notes:

  • No decidual reaction in the stroma.

DDx:

Images:

Subtypes

There are five subtypes:[1]

  1. Minimal atypia.
    • Usually early gestation.
  2. Early secretory pattern.
    • Mimics secretory endometrium: cytoplasmic vacuoles, central nucleus, palisading architecture.
  3. Secretory or hypersecretory pattern.
  4. Regenerative, proliferative or nonsecretory pattern.
  5. Monstrous cell pattern.

See also

References

  1. ↑ 1.0 1.1 1.2 Arias-Stella, J. (Jan 2002). "The Arias-Stella reaction: facts and fancies four decades after.". Adv Anat Pathol 9 (1): 12-23. PMID 11756756.
  2. ↑ 2.0 2.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236-7. ISBN 978-0470519035. . Cite error: Invalid <ref> tag; name "Ref_DCHH236-7" defined multiple times with different content
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