This is a case that needs close correlation with clinical manifestations. Based on what we see here, she appearantly has a "Complex endometrial glandular hyperplasia with ciliated cell change and secretory change". I do not appreciate nuclear atypia. Given her young age, I bet she has other clinical presentations and should check with clinician to see if she has ovrian cyst, long-standing menstruation problem, obese, and even worse, polycystic ovarian syndrome. Please communicate with clinician and let us know any other medical history which may link to this case. She is very young and disease is very focal. I will be very cautious to jump on "carcinoma" diagnosis. She should give chance to try hormone therapy.

Also I am not clear if this is endometrial biopsy or curettings. In US, it is usually do two step processes in evaluating endometrial diseases. EM biopsy will be performed first and then "curettings" if necessary, such as in this case. If this is a biopsy specimen, an EM curetting should be recommended to make sure no hidden disease worse than we see here.

图片很漂亮！

复杂性增生的背景下，局部腺体比较密集，而且有分泌现象，但是腺体没有共壁，也没有真正的“背靠背”，每个腺腔周围都有内膜间质相间隔。所以倾向于“复杂性增生，伴分泌局部分泌反应”。

如药物引起反应，部分有反应，部分无变化？有点疑问。

局部间质极少，但还像内膜间质，腺体复杂增生，细胞拥挤，但异型性不大，考虑不典型性复杂性增生。不敢报高分化分泌性癌。请专家指导！