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Difference between revisions of "Case 111"
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===Provided clinical history=== | ===Provided clinical history=== | ||
28 year old woman with a positive pregnancy test. | 28 year old woman with a positive pregnancy test. Cornual mass on ultrasound. No fetal heart identified. | ||
===Site=== | ===Site=== | ||
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{{hidden|Intermediate magnification|[[Image: Ariasstella changes in endometrium 20x.jpg |500px|link=|center|]] | {{hidden|Intermediate magnification|[[Image: Ariasstella changes in endometrium 20x.jpg |500px|link=|center|]] | ||
<center>Intermediate magnification. [[H&E stain]].</center>}} | <center>Intermediate magnification. [[H&E stain]].</center>}} | ||
===Differential diagnosis=== | ===Differential diagnosis=== | ||
{{hidden|Differential diagnosis|<center> | {{hidden|Differential diagnosis|<center>[[clear cell carcinoma]]</center>}} | ||
===Additional tests=== | ===Additional tests=== | ||
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===Diagnosis=== | ===Diagnosis=== | ||
{{hidden|Diagnosis|<center>ARIAS STELLA CHANGES/REACTION | {{hidden|Diagnosis|<center>ARIAS STELLA CHANGES/REACTION</center> | ||
<br> | |||
The diagnosis in this case is straightforward and relatively easy in this very young patient with a positive [[pregnancy]] test. However, it can be challenging in an older patient who comes in with bleeding. Arias Stella reaction shows endometrial glands lined by clear cells with atypia. Intranuclear inclusions (arrow) are often present. There can be occasional mitotic activity, which can further heighten its mimicry to [[clear cell carcinoma]]. Furthermore, the clear cells of Arias Stella are positive for Napsin and HNF1Beta, markers that are positive in clear cell carcinoma. [[AMACR]] is reportedly negative in Arias Stella while being positive in clear cell carcinoma although too few cases are tested to be confident of this claim.}} | |||
<br> | <br> | ||
===Other cases=== | ===Other cases=== | ||
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[[Category:Cases]] | [[Category:Cases]] | ||
[[Category:Cases in gynecological pathology]] | [[Category:Cases in gynecological pathology]] | ||
- | [[Category:Cases in gynecological pathology - junior]] | ||
[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level --> | [[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level --> | ||