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