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- 子宫内膜
This is not secretory phase endometrium because the stroma is nearly absent and no edema or predecidualization. There are 2 patterns shown in the photos: problematic mucinous lesion (left side of photo 1) and probable background proliferative or weakly proliferative endometrium (right side of photo 1). If what i see here represents the real pictures on slides, i would call this "endometrial intraepithelial neoplasia, EIN) or focal complex hyperplasia. I cannot see nuclear features well, so no comment on cytologic atypia. The last a few photos show back to back glands with negligible stroma, a worrisome sign for adenocarcinoma (would be mucinous adenocarcinoma). Recommend a formal dilatation and curettage (i suppose this is endometrial biopsy?) to exclude malignancy.
Be very careful with mucinous epithelium in endometrium.
Not sure about endometrial polyp. When this kind of morphology occurs within a endometrial polyp, it is still worrisome for hyperplasia or malignancy.
Patient's age is on the young side for endometrial adenocarcinoma, but 37 years old can have EM cancer too. The youngest i have seen is 33 years old, usually very obese or with ovarian problems.
| 以下是引用mingfuyu在2008-8-26 10:09:00的发言：
This is not secretory phase endometrium because the stroma is nearly absent and no edema or predecidualization. There are 2 patterns shown in the photos: problematic mucinous lesion (left side of photo 1) and probable background proliferative or weakly proliferative endometrium (right side of photo 1). If what i see here represents the real pictures on slides, i would call this "endometrial intraepithelial neoplasia, EIN) or focal complex hyperplasia. I cannot see nuclear features well, so no comment on cytologic atypia. The last a few photos show back to back glands with negligible stroma, a worrisome sign for adenocarcinoma (would be mucinous adenocarcinoma). Recommend a formal dilatation and curettage (i suppose this is endometrial biopsy?) to exclude malignancy. Be very careful with mucinous epithelium in endometrium. Not sure about endometrial polyp. When this kind of morphology occurs within a endometrial polyp, it is still worrisome for hyperplasia or malignancy. Patient's age is on the young side for endometrial adenocarcinoma, but 37 years old can have EM cancer too. The youngest i have seen is 33 years old, usually very obese or with ovarian problems. Thanks for your analysis! |
朱正龙
