Arias-Stella reaction

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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
  3. Félix, A.; Nogales, FF.; Arias-Stella, J. (Mar 2010). "Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens.". Int J Gynecol Pathol 29 (2): 185-8. doi:10.1097/PGP.0b013e3181b7015e. PMID 20173505.