Mikael Häggström [note 1]
Generally 10% neutral buffered formalin.
See also: General notes on fixation
A regular hysterectomy grossing is performed, but with the following sampling:
- 2 longitudinal sections through ecto/endocervix (1 anterior and 1 posterior)
- 2 longitudinal sections through upper endocervix/lower uterine segment (1 anterior and 1 posterior), immediately adjacent to the sections taken from the cervix
- 4 full-thickness representative sections of endomyometrium (2 anterior and 2 posterior)
- Transversely section the remaining anterior and posterior endomyometrium (~1 cm thick). Submit the entire endometrium from the lower uterine segment to the fundus, maintaining orientation.
- Submit entire fimbriae (longitudinally sectioned) and 2 representative cross-sections on each side.
- Look for signs of atypia or malignancy:
Endometrial hyperplasia: Cystically dilated endometrial glands lined by a single layer of columnar epithelium, without atypia.
Endometrial intraepithelial neoplasia (EIN), has the following criteria:
- Architectural gland crowding
- Altered cytology relative to background glands
- Minimum size of 1 mm
- Exclusion of adenocarcinoma
- Exclusion of mimics
Mitoses should also preferably be seen.
Endometrial adenocarcinoma, 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.
- Presence or absence of atypia.
See also: General notes on reporting
- ↑ 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.
- ↑ Nicole Cipriani (2020-06-22). Gross Pathology Manual. The University of Chicago Department of Pathology.
- ↑ 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
- ↑ Owings, Richard A.; Quick, Charles M. (2014). "Endometrial Intraepithelial Neoplasia ". Archives of Pathology & Laboratory Medicine 138 (4): 484–491. doi:10.5858/arpa.2012-0709-RA. ISSN 1543-2165.
- ↑ 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"
- ↑ 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.