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(merge in element of atypical complex hyperplasia) |
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{{ Infobox external links | {{ Infobox external links | ||
| Name = Complex endometrial hyperplasia | | Name = Complex endometrial hyperplasia | ||
| EHVSC = 10169 | | EHVSC = 10169 | ||
| EHVSC_mult = {{EHVSC3|10181|CEH with atypia}} | |||
| pathprotocols = | | pathprotocols = | ||
| wikipedia = | | wikipedia = | ||
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It is generally subdivided into '''complex endometrial hyperplasia without atypia''' and '''complex endometrial hyperplasia with atypia'''. | It is generally subdivided into '''complex endometrial hyperplasia without atypia''' and '''complex endometrial hyperplasia with atypia'''. | ||
===General=== | |||
*Usually premenopausal or perimenopausal women. | |||
*Associated with [[obesity]]. | |||
*High risk of transformation to [[endometrial carcinoma]] especially when with atypia. | |||
==Microscopic== | ==Microscopic== | ||
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*Nuclear enlargement. | *Nuclear enlargement. | ||
*Mitoses common. | *Mitoses common. | ||
* | *+/-Nuclear atypia: | ||
**Round nuclei ~ 2-3x the size of a lymphocyte. | |||
**Grey/translucent chromatin. | |||
**Nucleoli. | |||
Notes: | Notes: | ||
*Normal "gland-to-stroma ratio" is 1:3. | *Normal "gland-to-stroma ratio" is 1:3. | ||
*Two "touching" glands may be one gland in section. | *Two "touching" glands may be one gland in section. | ||
*Atypical nuclei often hide between non-typical nuclei, like peg cells in the [[fallopian tube]]. | |||
DDx: | DDx: | ||
*[[Endometrioid endometrial carcinoma]] - see ''[[endometrial carcinoma versus complex endometrial hyperplasia]]''. | *[[Endometrioid endometrial carcinoma]] - see ''[[endometrial carcinoma versus complex endometrial hyperplasia]]''. | ||
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www: | www: | ||
*[http://www.webpathology.com/image.asp?n=1&Case=568 Endometrial hyperplasia (webpathology.com)]. | *[http://www.webpathology.com/image.asp?n=1&Case=568 Endometrial hyperplasia (webpathology.com)]. | ||
*[http://www.webpathology.com/image.asp?n=2&Case=568 Complex endometrial hyperplasia with atypia (webpathology.com)]. | |||
==Sign out== | ==Sign out== | ||
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- ENDOMETRIAL POLYP WITH ONE ATYPICAL GLAND AND A SQUAMOUS MORULE. | - ENDOMETRIAL POLYP WITH ONE ATYPICAL GLAND AND A SQUAMOUS MORULE. | ||
- SCANT ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY. | - SCANT ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY. | ||
</pre> | |||
===Complex endometrial hyperplasia with atypia=== | |||
====Insufficient confluence for carcinoma==== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- COMPLEX ENDOMETRIAL HYPERPLASIA WITH ATYPIA, SEE COMMENT. | |||
COMMENT: | |||
The sections show architecturally complex crowded glands with focal | |||
morular squamous metaplasia and focal cribriforming. Desmoplasia | |||
is not identified. The degree of gland confluence is not considered | |||
sufficient for the diagnosis of endometrial carcinoma. Nuclear atypia | |||
is present focally. | |||
</pre> | |||
====Insufficient extent for carcinoma==== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- COMPLEX ENDOMETRIAL HYPERPLASIA WITH ATYPIA, SEE COMMENT. | |||
COMMENT: | |||
The sections show architecturally complex back-to-back glands with focal | |||
morular squamous metaplasia and cribriforming. Desmoplasia is not present. | |||
The extent, i.e. the size of the abnormality, is not considered sufficient | |||
for the diagnosis of endometrial carcinoma. | |||
</pre> | </pre> | ||
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==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Endometrial hyperplasia]] | [[Category:Endometrial hyperplasia]] |
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