Endometrial polyp with complex hyperplasia with atypia

Case contributed by Dr Mikkaela McCormack

Presentation

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.

Patient Data

Age: 70 years
Gender: Female
Pathology

H&E Images

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.   

Case Discussion

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%).    

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Case information

rID: 44259
Case created: 13th Apr 2016
Last edited: 14th Apr 2016
System: Gynaecology
Inclusion in quiz mode: Excluded

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