Difference between revisions of "Endometrial polyp"

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{{Comprehensiveness}}
 
{{Fixation - standard}}
 
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<gallery mode=packed heights=200>
 
<gallery mode=packed heights=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.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) and a thick-walled blood vessel (white arrow). The stroma is hemorrhagic.
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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 hemorrhagic in this case.
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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 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 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 uterine leiomyoma.jpg|Subserosal pedunculated uterine '''leiomyomas''' may present as endometrial polyps. They typically show smooth muscle in a whorled (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}}
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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>
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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>
 
</gallery>
  
 
==Reporting==
 
==Reporting==
 
Most importantly:
 
Most importantly:
*Presence or absence of atypia.
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*Benign versus malignant {{Moderate-begin}}or presence or absence of atypia.{{Moderate-end}}
Optionally, report the type of epithelium at both the surface and gland coverings.
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*{{Comprehensive-begin}}The size of the polyp.{{Comprehensive-end}}
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*{{Comprehensive-begin}}The type of epithelium at both the surface and gland coverings.{{Comprehensive-end}}
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Example of a minimal report:
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{|class=wikitable
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| Benign endometrial polyp.
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|}
 
{{Reporting}}
 
{{Reporting}}
 
{{Bottom}}
 
{{Bottom}}

Revision as of 08:18, 2 May 2022

Author: Mikael Häggström [note 1]

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation


Microscopic evaluation

The main objectives are:

  • 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.

Reporting

Most importantly:

  • Benign versus malignant (or presence or absence of atypia.)
  • ((The size of the polyp.))
  • ((The type of epithelium at both the surface and gland coverings.))

Example of a minimal report:

Benign endometrial polyp.

  See also: General notes on reporting


Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. Rao, Shalinee; Sundaram, Sandhya; Narasimhan, Raghavan (2009). "Biological behavior of preneoplastic conditions of the endometrium: A retrospective 16-year study in south India ". Indian Journal of Medical and Paediatric Oncology 30 (4): 131. doi:10.4103/0971-5851.65335. ISSN 0971-5851. 
    - Figure- available via license: Creative Commons Attribution 2.0 Generic
  2. Rao, Shalinee; Sundaram, Sandhya; Narasimhan, Raghavan (2009). "Biological behavior of preneoplastic conditions of the endometrium: A retrospective 16-year study in south India ". Indian Journal of Medical and Paediatric Oncology 30 (4): 131. doi:10.4103/0971-5851.65335. ISSN 0971-5851. 
    - Figure- available via license: Creative Commons Attribution 2.0 Generic
  3. Stewart, Colin J.R.; Crum, Christopher P.; McCluggage, W. Glenn; Park, Kay J.; Rutgers, Joanne K.; Oliva, Esther; Malpica, Anais; Parkash, Vinita; et al. (2019). "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 ". International Journal of Gynecological Pathology 38: S75–S92. doi:10.1097/PGP.0000000000000553. ISSN 0277-1691. 
    - "Figures - available via license: Creative Commons Attribution 4.0 International"
  4. Rabban, Joseph T.; Gilks, C. Blake; Malpica, Anais; Matias-Guiu, Xavier; Mittal, Khush; Mutter, George L.; Oliva, Esther; Parkash, Vinita; et al. (2019). "Issues in the Differential Diagnosis of Uterine Low-grade Endometrioid Carcinoma, Including Mixed Endometrial Carcinomas ". International Journal of Gynecological Pathology 38: S25–S39. doi:10.1097/PGP.0000000000000512. ISSN 0277-1691. 
  5. Mohamed Mokhtar Desouki. Uterus - Stromal tumors - Leiomyoma. pathology Outlines. Topic Completed: 1 August 2011. Revised: 15 December 2019

Image sources