Endometrium with squamous morules
| 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 in itself, strong assoc. with malignancy |
- Squamous morules redirects here.
Endometrium with squamous morules is important to recognize as squamous morules are strongly associated with malignancy.
General
- Benign finding in itself.
- Strong association 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.
- Smooth nuclear membrane.
- Pale nuclear staining.
- Fine chromatin pattern.
DDx:
- Complex endometrial hyperplasia with or without atypia.
- Endometrioid endometrial carcinoma.
- Uterine leiomyoma.
Images
SM - intermed. mag.
SM - high mag.
SM - high mag.
SM - high mag.
SM - very high mag.
SM - extremely high mag.
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ENDOMETRIUM, BIOPSY: - PROLIFERATIVE PHASE ENDOMETRIUM WITH A FOCUS OF SQUAMOUS MORULES, SEE COMMENT. COMMENT: There is no evidence of hyperplasia or malignancy in this biopsy; however, squamous morules are associated with hyperplasia and malignancy. Close follow-up and a re-biopsy (when clinically indicated) are recommended.
See also
References
- ↑ 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.
- ↑ 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.