Endometrium with squamous morules

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Endometrium with squamous morules is important to recognize as squamous morules are strongly associated with malignancy.

Endometrium with squamous morules
Diagnosis in short

Squamous morule. H&E stain.

LM well-circumscribed ball of squamoid cells -- cells have a whorled arrangement, moderate eosinophilic cytoplasm and a bland nucleus
LM DDx endometrial hyperplasia, endometrial carcinoma - esp. endometrioid endometrial carcinoma, uterine leiomyoma
Gross +/-endometrial thickening
Site endometrium

Associated Dx endometrial hyperplasia, endometrial carcinoma - esp. endometrioid endometrial carcinoma
Prognosis benign

General

  • Benign finding in itself.
  • Strong association of with malignancy.[1]
    • Associated with glandular lesions, i.e. endometrial hyperplasia and adenocarcinoma, not neoplastic squamous lesions.[2]

Microscopic

Features:

  • Well-circumscribed ball of squamoid cells:
    • Cells have a whorled arrangement.
    • Moderate eosinophilic cytoplasm.
    • Bland nucleus.

DDx:

Images

See also

References

  1. Nicolae, A.; Preda, O.; Nogales, FF. (Feb 2011). "Endometrial metaplasias and reactive changes: a spectrum of altered differentiation.". J Clin Pathol 64 (2): 97-106. doi:10.1136/jcp.2010.085555. PMID 21126963.
  2. Lin, MC.; Lomo, L.; Baak, JP.; Eng, C.; Ince, TA.; Crum, CP.; Mutter, GL. (Feb 2009). "Squamous morules are functionally inert elements of premalignant endometrial neoplasia.". Mod Pathol 22 (2): 167-74. doi:10.1038/modpathol.2008.146. PMID 19180120.