Difference between revisions of "Arias-Stella reaction"

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

Revision as of 10:26, 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