Endometrial Polyps With Atypical (Bizarre) Stromal Cells

Tai, Lisa H.; Tavassoli, Fattaneh A.

doi:10.1097/00000478-200204000-00014

Cited by 54 publications

(21 citation statements)

References 17 publications

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“…These lesions were described predominantly in the context of polyps (1,2). To our knowledge, no lesion identical to ours has been reported thus far.…”

Section: Discussionsupporting

confidence: 70%

“…They suggested these cells to represent a primitive cell population originating from multipotent mesenchymal cells that have the ability to differentiate toward either smooth muscle or endometrial stromal lineage because of immunohistochemical findings in which the atypical stromal cells stain with endometrial stromal and smooth muscle markers. In their study, all cases (100%) stained with vimentin, estrogen receptor, progesterone receptor, and androgen receptor, and 37% were positive for CD10 (1).…”

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confidence: 89%

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Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

Usubütün

Karaman²,

Ayhan³

et al. 2005

International Journal of Gynecological Pathology

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We presented a polypoid leiomyoma with bizarre nuclei having atypical endometrial stromal cells adjacent to the leiomyoma. Although atypical stromal cells of the female genital tract have been described, to our knowledge, no lesion identical to ours has been reported thus far. These atypical cells may be mistaken for malignant cells on histologic examination, especially in small endometrial samples. To differentiate these kinds of atypical-featured lesions from sarcoma is important, especially in curettage materials. The etiology and precise nature of multinucleated giant cells and atypical stromal cells in the endometrium are unclear. To prevent radical surgery, pathologists must be familiar with these atypical cells in the female genital tract.

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“…These lesions were described predominantly in the context of polyps (1,2). To our knowledge, no lesion identical to ours has been reported thus far.…”

Section: Discussionsupporting

confidence: 70%

mentioning

confidence: 89%

Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

Usubütün

Karaman²,

Ayhan³

et al. 2005

International Journal of Gynecological Pathology

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show abstract

“…48 Some endometrial polyps may have a uniformly cellular stroma and may contain abundant smooth muscle (adenomyomtous polyp) or atypical stromal cells with a symplastic appearance (Figure 12b). 49 These findings have no clinical significance and should not result in the misdiagnosis as adenosarcoma.…”

Section: Modern Pathology (2016) 29 S78-s91mentioning

confidence: 99%

A practical approach to the diagnosis of mixed epithelial and mesenchymal tumours of the uterus

McCluggage

2016

Modern Pathology

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The current 2014 World Health Organization (WHO) Classification of mixed epithelial and mesenchymal tumours of the uterus includes categories of carcinosarcoma, adenosarcoma, adenofibroma, adenomyoma and atypical polypoid adenomyoma, the last two lesions being composed of an admixture of benign epithelial and mesenchymal elements with a prominent smooth muscle component. In this review, each of these categories of uterine neoplasm is covered with an emphasis on practical tips for the surgical pathologist and new developments. In particular, helpful clues in the distinction between carcinosarcoma and dedifferentiated endometrial carcinoma will be discussed. In addition, salient features to help distinguish between adenofibroma, adenosarcoma, embryonal rhabdomyosarcoma and other mesenchymal neoplasms in the differential diagnosis will be outlined. Finally, a discussion of adenomyoma and its main differential diagnostic considerations will be covered.

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“…These cases usually are accidental findings, however presence of cells with large, hyperchromatic, multilobulated nuclei or multinucleated stromal cells which can be distributed in focal or multimodal pattern, may be interpreted as a worrisome finding. Smudged pattern of nuclear chromatin similar to atypical leiomyoma, lack of periglandular cuffing, absence of mitotic activity and very low proliferative index in these cells which can be confirmed by very low immunoreactivity to ki67 are useful findings for rule out of malignancy (15,16) (Figure 3). …”

Section: Histologic Featuresmentioning

confidence: 88%

Histologic Features and Differential Diagnosis of Endometrial Polyps; An Update and Review

Tabrizi¹

2016

IJWHR

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IntroductionAmong the endometrial lesions, endometrial polyps (EPs) are commonly seen in the premenopausal and postmenpuasal age group and are found in 25% of endometrial specimens performed for abnormal uterine bleeding (1). EPs are generally considered as local hyperplasitic lesions of endometrial stroma which covered by epithelium. These lesions are seen single or multiple, sessile or pedunculated and the size range differs from millimetres to centimetres. In 10% of cases they mimic endocervical polyp due to prolapsus from external os (2,3). In a case of sufficient clinical, hysteroscopic and imaging information, the histologic diagnosis is usually straightforward. From clinical and prognostic standpoint, it should be emphasized that rarely these lesion may harbour premalignant and malignant lesions particularly in older age group. Therefore careful histologic examination for rule out of raised malignant lesions should be considered. In the other hand in rare cases these lesions may show metastatic involvement particularly from lobular breast carcinoma. Prevalence of these lesions in association with clinical presentation and histologic features will be presented and differential diagnosis with special emphasis on rule out of malignant lesions will be discussed. PrevalenceIn the 2402 office hysteroscopy performed on women with mean age of 39.4 years old for several indications, the prevalence of EP was 27.2% (4). Based on used diagnostic method and study group the mentioned rate varies between 6% to 32% and this rate increases with age (5-7). In another large study carried out on 686 Danish women in range of 20-79 years of old who accepted to be examined by both transvaginal sonography and saline contrast sonohysterography, the prevalence of EP was 7.8% (5). In this study the EPs were rare (0.9%) between young women and in women older than 30 years the prevalence was 9.2%. EPs are rarely found in OCP user whereas in the women who were on hormone replacement therapy the prevalence was much higher (2.1% vs. 25%) (5). Respect to hormones as an etiologic factor, high frequency of endometrial hyperplasia was found in the non-polyploid region of endometrium in premenopausal and postmenopausal women (8). Clinical PresentationThe usual clinical presentations of EPs may include menorrhagia, intermenstrual bleeding, postmenopausal bleeding and infertility. However the majority of patients may be asymptomatic and the prevalence could be similar in symptomatic and asymptomatic women (5). These findings indicates that there is no consistent relationship between abnormal uterine bleeding and existence of EPs and why hysteroscopic resection of EPs does not always result in relief of symptoms (9). A pathologist should be alert that in the most cases of protruded EPs, the usual clinical diagnosis will be endocervical polyp by the gynaecologist. Regard to tamoxifen, EPs are the most common pathology that could be seen in these patients. In these patients the prevalence of AbstractAmong the endometrial lesions, endometrial poly...

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Endometrial Polyps With Atypical (Bizarre) Stromal Cells

Cited by 54 publications

References 17 publications

Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

A practical approach to the diagnosis of mixed epithelial and mesenchymal tumours of the uterus

Histologic Features and Differential Diagnosis of Endometrial Polyps; An Update and Review

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