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Endometrial polyp

2,520 bytes added, 08:18, 2 May 2022
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{{Comprehensiveness}}
{{Fixation - standard}}
{{Fixation - general notes}}
==Microscopic evaluation==
[[File:Endometrial histopathologies and cytopathologies.jpg|thumb|400px|Histopathologic and cytopathologic images.<br>(A) proliferative endometrium (Left: HE × 400) and proliferative endometrial cells (Right: HE × 100)<br>(B) secretory endometrium (Left: HE × 10) and secretory endometrial cells (Right: HE × 10)<br>(C) atrophic endometrium (Left: HE × 10) and atrophic endometrial cells (Right: HE × 10)<br>(D) mixed endometrium (Left: HE × 10) and mixed endometrial cells (Right: HE × 10)<br>(E): endometrial atypical hyperplasia (Left: HE × 10) and endometrial atypical cells (Right: HE × 200)<br>(F) endometrial carcinoma (Left: HE × 400) and endometrial cancer cells (Right: HE × 400).]]
The main objectives are:
*Confirm an Making a '''diagnosis''' of endometrioid polyp.An endometrial polyp may be diagnosed in the presence of 2 of the following 3::*Thick-walled vessels:*Collagenous stroma:*Epithelium on at least 3 sides*Look for signs of '''atypia or malignancy'''.<gallery mode=packedheights=200>
File:Histopathology of non-complex endometrial polyp without atypia.jpg|'''Non-complex endometrial polyp without atypia''', with a thick-walled blood vessel in middle - typical of endometrial polyps. Glands are regular.
File:Histopathology of non-complex endometrial polyp without atypia, with tubal metaplasia.jpg|'''Non-complex endometrial polyp without atypia''', with tubal metaplasia (black arrow, showing ciliated epithelium) and a thick-walled blood vessel (white arrow). The stroma is hemorrhagicin this case.File:Myometrium versus endometrial stroma versus endometrial polyp stroma.jpg|Myometrium (smooth muscle cells) versus endometrial stroma (more cellular) versus '''endometrial polyp stroma''' (more collagenous).{{MH}}
File:Histopathology of complex hyperplasia without atypia.jpg|'''Complex hyperplasia without atypia''': Cystically dilated endometrial glands lined by a single layer of columnar epithelium.<ref>{{cite journal|last1=Rao|first1=Shalinee|last2=Sundaram|first2=Sandhya|last3=Narasimhan|first3=Raghavan|title=Biological behavior of preneoplastic conditions of the endometrium: A retrospective 16-year study in south India|journal=Indian Journal of Medical and Paediatric Oncology|volume=30|issue=4|year=2009|pages=131|issn=0971-5851|doi=10.4103/0971-5851.65335}}<br>- [https://www.researchgate.net/figure/Cystically-dilated-endometrial-glands-lined-by-a-single-layer-of-columnar-epithelium_fig1_46256480 Figure- available via license: Creative Commons Attribution 2.0 Generic]</ref>
File:Histopathology of complex hyperplasia with atypia.jpg|'''Complex hyperplasia with atypia''': Closely packed endometrial glands with sparse intervening stroma and stratification of the lining epithelium. Epithelial cells show cytological atypia with high nucleocytoplasmic ratio, irregular clumping of nuclear chromatin, and mitotic figures.<ref>{{cite journal|last1=Rao|first1=Shalinee|last2=Sundaram|first2=Sandhya|last3=Narasimhan|first3=Raghavan|title=Biological behavior of preneoplastic conditions of the endometrium: A retrospective 16-year study in south India|journal=Indian Journal of Medical and Paediatric Oncology|volume=30|issue=4|year=2009|pages=131|issn=0971-5851|doi=10.4103/0971-5851.65335}}<br>- [https://www.researchgate.net/figure/Closely-packed-endometrial-glands-with-sparse-intervening-stroma-and-stratification-of_fig2_46256480 Figure- available via license: Creative Commons Attribution 2.0 Generic]</ref>
File:Histopathology of low-grade (FIGO grade 1) endometrial endometrioid adenocarcinoma.png|'''[[Endometrial adenocarcinoma]]'''<ref>{{cite journal|last1=Stewart|first1=Colin J.R.|last2=Crum|first2=Christopher P.|last3=McCluggage|first3=W. Glenn|last4=Park|first4=Kay J.|last5=Rutgers|first5=Joanne K.|last6=Oliva|first6=Esther|last7=Malpica|first7=Anais|last8=Parkash|first8=Vinita|last9=Matias-Guiu|first9=Xavier|last10=Ronnett|first10=Brigitte M.|title=Guidelines to Aid in the Distinction of Endometrial and Endocervical Carcinomas, and the Distinction of Independent Primary Carcinomas of the Endometrium and Adnexa From Metastatic Spread Between These and Other Sites|journal=International Journal of Gynecological Pathology|volume=38|year=2019|pages=S75–S92|issn=0277-1691|doi=10.1097/PGP.0000000000000553}}<br>- "Figures - available via license: Creative Commons Attribution 4.0 International"</ref>, most commonly endometrioid, in which case low-grade carcinoma is distinguished from hyperplasia with atypia by the presence of glandular crowding with endometrial stromal exclusion, and significant cribriform, confluent glandular, labyrinthine, papillary/villoglandular, or non-squamous solid architecture.<ref name="RabbanGilks2019">{{cite journal|last1=Rabban|first1=Joseph T.|last2=Gilks|first2=C. Blake|last3=Malpica|first3=Anais|last4=Matias-Guiu|first4=Xavier|last5=Mittal|first5=Khush|last6=Mutter|first6=George L.|last7=Oliva|first7=Esther|last8=Parkash|first8=Vinita|last9=Ronnett|first9=Brigitte M.|last10=Staats|first10=Paul|last11=Stewart|first11=Colin J.R.|last12=McCluggage|first12=W. Glenn|title=Issues in the Differential Diagnosis of Uterine Low-grade Endometrioid Carcinoma, Including Mixed Endometrial Carcinomas|journal=International Journal of Gynecological Pathology|volume=38|year=2019|pages=S25–S39|issn=0277-1691|doi=10.1097/PGP.0000000000000512}}</ref>
File:Histopathology of a leiomyoma with fascicular growth.jpg|Subserosal pedunculated uterine '''leiomyomas''' may present as endometrial polyps. They typically show smooth muscle in a fascicular pattern<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/uterusleiomyoma.html|title=Uterus - Stromal tumors - Leiomyoma|author=Mohamed Mokhtar Desouki|website=pathology Outlines}} Topic Completed: 1 August 2011. Revised: 15 December 2019</ref> {{further|Smooth muscle tumor|linebreak=no}}
</gallery>
==Reporting==
Most importantly:
*Benign versus malignant {{Moderate-begin}}or presence or absence of atypia.{{Moderate-end}}
*{{Comprehensive-begin}}The size of the polyp.{{Comprehensive-end}}
*{{Comprehensive-begin}}The type of epithelium at both the surface and gland coverings.{{Comprehensive-end}}
 
Example of a minimal report:
{|class=wikitable
| Benign endometrial polyp.
|}
{{Reporting}}
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