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Difference between revisions of "Atrophic endometrium"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Inactive endometrial epithelium -- high mag.jpg | |||
| Width = | |||
| Caption = Inactive endometrial epithelium. [[H&E stain]]. | |||
| Micro = nonproliferative endometrial epithelium, +/-benign stroma with normal gland-to-stroma ratio, no nuclear atypia | |||
| Subtypes = | |||
| LMDDx = type 2 [[endometrial carcinoma]]s, esp. [[serous endometrial carcinoma]], [[proliferative phase endometrium]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[endometrium]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = postmenopausal | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = normal postmenopausal finding | |||
| ClinDDx = atrophy, [[endometrial hyperplasia]], [[endometrial carcinoma]], other gynecologic cancers | |||
}} | |||
'''Atrophic endometrium''', also '''inactive endometrium''', is the normal finding in postmenopausal women. | |||
It is also known as '''atrophy of the endometrium''' and '''endometrial atrophy'''. | |||
==General== | |||
*Endometrium of normal postmenopausal women. | |||
**Menopause typically happens at around 50 years old. | |||
*Very common diagnosis. | |||
**Atrophy may be associated with bleeding and therefore biopsied to rule-out hyperplasia and malignancy. | |||
==Gross== | |||
*Thin endometrium. | |||
==Microscopic== | |||
Features: | |||
*Glands - small columnar cells: | |||
**Moderate quantity of eosinophilic cytoplasm. | |||
**Ovoid (palisaded) nuclei +/- nuclear pseudostratification.<ref name=pmid16873562>{{Cite journal | last1 = McCluggage | first1 = WG. | title = My approach to the interpretation of endometrial biopsies and curettings. | journal = J Clin Pathol | volume = 59 | issue = 8 | pages = 801-12 | month = Aug | year = 2006 | doi = 10.1136/jcp.2005.029702 | PMID = 16873562 | PMC = 1860448 }}</ref> | |||
**Eosinophilic cytoplasm. | |||
**No mitoses. | |||
*Architecture: | |||
**+/-Cystic dilation. | |||
Notes: | |||
*If a woman is truly postmenopausal, mitoses in the glandular epithelium is pathologic until demonstrated otherwise. | |||
**The exceptions are [[benign endometrial polyp]], [[uterine prolapse]], and possibly inflammation (e.g. the person has had several biopsy attempts and was seeded with pathogens). | |||
DDx: | |||
*[[Proliferative phase endometrium]] - esp. if there is pseudostratification. | |||
*[[Serous carcinoma of the endometrium]]. | |||
===Images=== | |||
<gallery> | |||
Image: Inactive endometrial epithelium -- intermed mag.jpg | Inactive endometrium - intermed. mag. | |||
Image: Inactive endometrial epithelium -- high mag.jpg | Inactive endometrium - high mag. | |||
</gallery> | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860448/figure/fig1/ Atrophic endometrium (nih.gov)].<ref name=pmid16873562>{{Cite journal | last1 = McCluggage | first1 = WG. | title = My approach to the interpretation of endometrial biopsies and curettings. | journal = J Clin Pathol | volume = 59 | issue = 8 | pages = 801-12 | month = Aug | year = 2006 | doi = 10.1136/jcp.2005.029702 | PMID = 16873562 }} | |||
</ref> | |||
==Sign out== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- NON-PROLIFERATIVE ENDOMETRIUM. | |||
- BENIGN SQUAMOUS EPITHELIUM WITH METAPLASTIC CHANGE. | |||
- SCANT ENDOCERVICAL MUCOSA WITH REACTIVE CHANGES. | |||
</pre> | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- NON-PROLIFERATIVE ENDOMETRIUM. | |||
- BENIGN STRIPPED ENDOCERVICAL EPITHELIUM. | |||
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Micro==== | |||
The sections show small fragments of endometrium. The gland-to-stroma ratio is normal. The glands are small and round, and have a pseudostratified epithelium. | |||
Mitotic figures are not identified within the glands or stroma. No stromal condensation is apparent. No secretions are in the glands. No nuclear atypia is apparent. | |||
Scant benign endocervical tissue (stripped epithelium and mucosa) is present. | |||
===Limited stroma=== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- STRIPPED NONPROLIFERATIVE ENDOMETRIAL EPITHELIUM; NO APPRECIABLE STROMA PRESENT. | |||
- SCANT ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS. | |||
- MINUTE FRAGMENTS OF SQUAMOUS EPITHELIUM WITHOUT APPARENT PATHOLOGY. | |||
</pre> | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- SCANT STRIPPED NON-PROLIFERATIVE ENDOMETRIAL EPITHELIUM. | |||
- VERY SMALL FRAGMENT OF ENDOMETRIAL STROMA. | |||
- TUBAL METAPLASTIC EPITHELIUM. | |||
</pre> | |||
<pre> | |||
ENDOMETRIUM, ASPIRATION: | |||
- SMALL FRAGMENTS OF NONPROLIFERATIVE ENDOMETRIAL EPITHELIUM ATTACHED TO | |||
A VERY SMALL AMOUNT OF STROMA. | |||
- MINUTE BENIGN FRAGMENT OF SQUAMOUS EPITHELIUM. | |||
- MUCOUS AND INFLAMMATORY CELLS. | |||
COMMENT: | |||
The sample is scant given the history of 'thickened endometrium'. | |||
</pre> | |||
====Micro==== | |||
The sections show stripped endometrial epithelium and stripped tubal-type epithelium. | |||
No mitotic activity is identified. No nuclear atypia is apparent. A small fragment of | |||
definite endometrial stroma is present. The gland-to-stroma ratio cannot be assessed due | |||
to the limited stroma. | |||
==See also== | |||
*[[Endometrium]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Endometrium]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||