Endometrium with changes due to selective progesterone receptor modulators

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Endometrium with changes due to selective progesterone receptor modulators
Diagnosis in short

Micrograph showing endometrium with changes due to a SPRM. H&E stain.

LM glandular changes - extensive cystic dilatation, inactive appearing glandular epithelium or abortive subnuclear vacuolization, rare mitoses or apoptotic cells, abnormal stromal vessels (common)
LM DDx endometrial hyperplasia
Site endometrium

Associated Dx uterine leiomyomas
Clinical history use of SPRM
Prognosis benign
Treatment (none)

Endometrium with changes due to selective progesterone receptor modulator may mimic endometrial hyperplasia.

Selective progesterone receptor modulators, abbreviated SPRMs, are a class of drugs that block the action of progesterone. They are used to treat uterine fibroids.[1]

General

  • Ulipristal - trade name Fibristal.
  • May be used as an emergency contraceptive.[2]

Microscopic

Features:[1]

  • Glandular changes - extensive cystic dilatation.
  • Inactive appearing glandular epithelium or abortive subnuclear vacuolization.
  • Rare mitoses and apoptosis.
  • Abnormal stromal vessels - common.

DDx:

Images

See also

References

  1. 1.0 1.1 Williams, AR.; Bergeron, C.; Barlow, DH.; Ferenczy, A. (Nov 2012). "Endometrial morphology after treatment of uterine fibroids with the selective progesterone receptor modulator, ulipristal acetate.". Int J Gynecol Pathol 31 (6): 556-69. doi:10.1097/PGP.0b013e318251035b. PMID 23018219.
  2. Whitaker, LH.; Williams, AR.; Critchley, HO. (Aug 2014). "Selective progesterone receptor modulators.". Curr Opin Obstet Gynecol 26 (4): 237-42. doi:10.1097/GCO.0000000000000082. PMID 24950125.