Anovulatory endometrium
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Anovulatory endometrium, abbreviated AE, is common perimenopausal finding. It is a diagnosis that is inferred from the clinical context.
General
- Individuals usually perimenopausal.
Relation to disordered proliferative endometrium
Some consider disordered proliferative endometrium (DPE) a synonym for anovulatory endometrium.[1]
Libre Pathology separates the two. DPE has prominent gland dilation (reminiscent of simple endometrial hyperplasia) and may not have shedding. AE has shedding without gland dilation.
Microscopic
Features:
- Shedding:
- Stromal condensation.
- Apoptotic endometrial epithelium.
- Weakly proliferative glands or non-proliferative glands.
DDx:
- Disordered proliferative phase - gland dilation.
- Simple endometrial hyperplasia.
- Menstrual endometrium - should have mitoses,[2] abundant PMNs.
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ENDOMETRIUM, CURETTAGE: - FRAGMENTED PROLIFERATIVE ENDOMETRIUM WITH EVIDENCE OF SHEDDING, WITHOUT ABUNDANT NEUTROPHILS, SEE COMMENT. - NO EVIDENCE OF HYPERPLASIA. - NEGATIVE FOR MALIGNANCY. COMMENT: The changes are compatible with anovulatory bleeding.
ENDOMETRIUM, CURETTAGE: - PROLIFERATIVE ENDOMETRIUM WITH SMALL ROUND GLANDS AND SHEDDING, SEE COMMENT. - BENIGN ENDOCERVICAL MUCOSA. - NEGATIVE FOR HYPERPLASIA. - NEGATIVE FOR MALIGNANCY. COMMENT: The changes are suggestive of anovulatory bleeding.
ENDOMETRIUM, BIOPSY: - BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION, AND EVIDENCE SUGGESTIVE OF EROSIONS (SIDEROPHAGES, INCREASED BLOOD VESSEL DENSITY). - SMALL NONPROLIFERATIVE ENDOMETRIAL GLANDS WITH RARE NEUTROPHILS AND RARE APOPTOTIC CELLS, WITH BALLS OF CONDENSED ENDOMETRIAL STROMA, SEE COMMENT. - NEGATIVE FOR ENDOMETRIAL HYPERPLASIA AND NEGATIVE FOR DYSPLASIA. COMMENT: The changes are suggestive of anovulatory bleeding.
ENDOMETRIUM, ASPIRATION: - PSEUDOSTRATIFIED ENDOMETRIAL EPITHELIUM WITHOUT APPARENT PROLIFERATION, WITH APOPTOTIC CELLS AND LIMITED STROMA WITH RARE (STROMAL) CONDENSATION -- COMPATIBLE WITH SHEDDING. - MINUTE FRAGMENTS OF BENIGN ENDOCERVICAL EPITHELIUM. - NO EVIDENCE OF HYPERPLASIA.
See also
References
- ↑ URL: http://www.surgpath4u.com/caseviewer.php?case_no=382. Accessed on: 9 May 2013.
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 237. ISBN 978-0470519035.