Atypical polypoid adenomyoma of the uterus

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Atypical polypoid adenomyoma of the uterus
Diagnosis in short

Atypical polypoid adenomyoma. H&E stain.

LM endometrial glands with irregular (non-ovoid) shapes, benign smooth muscle around the glands, morular squamous metaplasia
LM DDx endometrioid endometrial carcinoma, endometrium with squamous morules, endocervical adenocarcinoma
Gross lower uterine segment lesion
Site uterus

Clinical history reproductive age women
Prevalence rare
Prognosis benign

Atypical polypoid adenomyoma of the uterus is a rare benign lesion of the uterus.

It is usually referred to simply as atypical polypoid adenomyoma (abbreviated APA).

General

  • Very rare.[1]
  • Benign.[2]
  • Reproductive age women.

Gross

  • Lower uterine segment.

Microscopic

Features:[2]

  • Glands with irregular (non-ovoid) shapes.
  • Benign smooth muscle around the glands - key feature.
  • Morular squamous metaplasia - balls of squamous cells - very common.
  • Nuclear atypia (mild).

DDx:

Images

www:

IHC

Features (glandular component):[1]

  • AE1/AE3 +ve.
  • CK7 +ve.
  • ER +ve.
  • PR +ve.

Significant negative (glandular component):[1]

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ENDOMETRIUM, CURETTAGE:
- ATYPICAL POLYPOID ADENOMYOMA.

COMMENT:
Atypical polypoid adenomyomas are considered to be benign lesions; however, 
they may persist or recur in up to half of patients.

See also

References

  1. 1.0 1.1 1.2 Terada, T. (Oct 2011). "Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases.". Ann Diagn Pathol 15 (5): 338-41. doi:10.1016/j.anndiagpath.2011.03.008. PMID 21684185.
  2. 2.0 2.1 Jakus, S.; Edmonds, P.; Dunton, C.; Holland, G. (Jan 2002). "Atypical polypoid adenomyoma mimicking cervical adenocarcinoma.". J Low Genit Tract Dis 6 (1): 33-8. PMID 17050990.