Endometrial polyp with complex hyperplasia with atypia
This 70-year-old's curetting specimen was received without any accompanying clinical information. The curetted tissue fragments measured 15 x 10 x 4 mm in aggregate.
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The sections consist of background endometrium displaying changes of cystic atrophy. Several fragments have a polypoid appearance, which in areas show an increased gland-to-stroma ratio and a spindled, fibrous stroma. Focally, the glandular architecture is crowded, with complex cribriform patterns. These glands display cellular stratification and crowding, with pleomoprhic, enlarged nuclei showing coarse chromatin, prominent nucleoli and scattered mitotic figures.
Note: No evidence of malignancy was present within the tissue sampled.
Making the finding of endometrial hyperplasia within a polyp has clinical implications for the patient’s future treatment – making a diagnosis of atypical hyperplasia can result in a hysterectomy. Where atypical hyperplasia is identified in a polyp, there’s a high chance there will be atypical hyperplasia or carcinoma within the non-polypoid endometrium (>50%).
- Mittal K, Da Costa D. Endometrial hyperplasia and carcinoma in endometrial polyps: clinicopathologic and follow-up findings. Int J Gynecol Pathol. 2008 Jan;27(1):45-8. PubMed Abstract