Difficult to make the dx by above photos. This is a gray zone area in the daily practice for gynecolof\gist, ach vs focal ca in the background of ACH. Agree with Fyshan's comment. People still use Dr. Norris and Kurman's criteria for em-ca---cribriform or papillary structures and back to back glands without stroma between for 2 mm.  I do not see the these tructures clearly in above photos.

Not for your case:

1. In clinical practice we also consider patients' age for some borderline cases. We may be more easy to call cancer in older patients than younger patients.  Now for old patients surgens will do the hystectomy for both cancer and ACH.

2. Sometimes it is really difficult to call some cases ACH or focal cancer. We may use the terminology-- the ACH with focal glandular architecture atypia approching the diagnosis of focal  well-differentiated endometrioid carcinoma.

We are chicken sometimes and have to keep some space for ourselves and try to protect ourselves..

Just for your reference.

cqz

 Agree with above comment.

To dx of endometrial Ca, you need to see invasion: ie, pink fibroblast cells around glands or cribiform features (not simple back to back, many back to back glands melt together)  or intralumenal necrosis. I have not seen those on the above photos.

Good luck.