By Anna Sienko
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Extra resources for Advances in Surgical Pathology: Endometrial Carcinoma
Both glands and villoglandular structures are included in the glandular component. , pseudostratification and mitotic activity) (Fig. 3-2), except in the uncommon cases of hyperplasia with secretory changes (Fig. 3-3). FIGURE 3-1: Endometrial hyperplasia. The glandular proliferation has shifted the gland-to-stroma ratio from 2:1 to 3:1 (the endometrial stroma represents less than one-half to one-third of the crosssectional area of the proliferation). Chapter 3 • Endometrial Hyperplasia 19 FIGURE 3-2: Endometrial epithelium usually demonstrates proliferative features such as pseudostratification and mitoses (arrows).
Note how the cells lining the neoplastic endometrial glands merge with the spindle cells (arrows). Chapter 4 • Endometrial Carcinoma 49 cells as a true sarcoma (Fig. 4-10A–B). The use of a keratin cocktail and epithelial membrane antigen (EMA) may assist in making the correct diagnosis; however, these immunostains can be only focally positive. CLEAR CELL CHANGES The cytoplasm of the neoplastic cells in endometrioid adenocarcinoma can be focally clear. 19 This type of neoplasm shows a proliferation of small glands lined by one or more layers of cuboidal, columnar, or flattened cells, with a variable amount of amphophilic or mucin-rich cytoplasm.
14 Secretory Variant This rare variant of endometrioid adenocarcinoma is usually seen in postmenopausal patients, although it can also occur in premenopausal patients, with or without a history of endogenous or exogenous progestational effect. Its histologic hallmark is the presence of intracytoplasmic vacuoles in most of the neoplastic cells. These vacuoles can be supranuclear, subnuclear, or both (Fig. 15,16 Ciliated Variant This uncommon variant of endometrial adenocarcinoma shows neoplastic glands lined predominantly by ciliated cells (Fig.
Advances in Surgical Pathology: Endometrial Carcinoma by Anna Sienko