Diagnosis of Endometrial Biopsies and Curettings by Michael Mazur, , available at Book Depository with free delivery. Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach. Veli Marjoniemi. x. Veli Marjoniemi. Search for articles by this author. Department of. Generally, this should comprise a formal curetting rather than an outpatient biopsy. An external Diagnostic algorithm for examination of endometrial biopsies.

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Biopsy pathology of the endometrium. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide.

endomterial Previously, endometrial biopsy specimens were largely obtained by dilatation and curettage carried out under general anaesthesia. Hum Pathol 29 — The Best Books of The text is structured so as to present a logical approach to formulating a pathologic diagnosis from the diverse array of tissue received in the surgical pathology laboratory. Am J Surg Pathol 28 — By contrast, most metaplastic processes are oestrogen receptor positive and exhibit a weak heterogeneous pattern of p53 staining.

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Related articles in Google Scholar. Most endometrial specimens are now taken at outpatients by pipelle or other techniques, with the result that many biopsy specimens contain scant, or even no, endometrial tissue. Problems in recognising plasma cells may occur, especially on histological sections that are less than optimal.

Diagnosis of Endometrial Biopsies and Curettings : A Practical Approach

The potential benign mimics of endometrial hyperplasia are listed in box 1. In atypical hyperplasia, the nuclear changes are often accompanied by cytoplasmic changes, such that the cells have more abundant, often eosinophilic, cytoplasm. Atypical polypoid adenomyoma Only a few comments will be made regarding atypical polypoid adenomyoma APAconcentrating on those issues that are likely to pertain to endometrial biopsy specimens.

Stromal and glandular mitoses are commonly found in a proliferative endometrium.


Endometrial hyperplasia In my experience, various aspects related to endometrial hyperplasia commonly create problems for pathologists.

In case of florid epithelial metaplasia, a hyperplastic or malignant process should be looked for and excluded. Polyps are a common cause of abnormal bleeding in premenopausal and postmenopausal women.

If there is any endometrial tissue, no matter how little, I do not categorise the specimen as inadequate. You do not currently have access to this article. Accepted Nov Histopathology 35 44— Cervical tissue, either cervical glandular or squamous epithelium with or without stroma, may be present and should be examined to exclude major pathology.

My approach to the interpretation of endometrial biopsies and curettings

A report of 19 cases. This may result in consideration of a serous carcinoma or endometrial intraepithelial carcinoma. Clinical history In evaluating an endometrial biopsy specimen, an adequate clinical history is important, including the age of the patient and the reason for the biopsy. Crushed endometrial glands and stroma may be extremely cellular and can cause concern.

A diagnosis of a papillary adenocarcinoma should not be made without specification of the morphological type. Suggested alternative terminology for classification of precursor lesions of endometrioid adenocarcinoma EIN terminology has been extensively championed by Mutter and coworkers.

Adv Anat Pathol 10 — Am J Obstet Gynecol — Cytoplasmic changes, including increased cytoplasmic eosinophilia, may also be seen in various endometrial metaplasias, such as ciliated metaplasia.

Am J Surg Pathol 8 — The gynaecologist hiopsies believe that a polyp is present, but histological examination shows a cyclical endometrium, often secretory in type, reflecting the fact that an abundant secretory endometrium may have a polypoid appearance. In a small percentage of cases without these features, there is vaginal recurrence after hysterectomy.

Generally, this should comprise a formal curetting rather than an outpatient biopsy.

Diagnosis of Endometrial Biopsies and Curettings : Michael Mazur :

Mixed epithelial ans mesenchymal tumours. You could not be signed in. In these areas, the stromal cells are often mildly atypical and it is here that mitotic figures are usually identified, although these may be sparse and may vary in number from area to area. World Health Organization classification of tumours. The pathologist is faced with making a decision on whether the biopsy specimen is adequate.


Polyp cancers may be endometrioid in type, but serous proliferations, serous carcinoma or its precursor lesion endometrial intraepithelial carcinoma EIChave a particular propensity to arise in or be associated with otherwise benign endometrial polyps. In many cases of postmenopausal bleeding, the patient is not actually postmenopausal but rather is perimenopausal, with a prolonged interval between periods.

Tissue from the lower uterine segment may morphologically be confused with an endometrial polyp, as the stroma has a fibrous appearance and the glands are often few in number. Am J Surg Pathol 25 — Int J Gynecol Pathol 14 — Int J Gynecol Pathol 7 — Chapman and Hall, — Support Center Support Center. In any case, the management of simple endometrial hyperplasia and disordered proliferative endometrium is usually identical, in the form of progestogenic compounds. Endometrial carcinoma Issues relevant only to the diagnosis of endometrial carcinoma on biopsy specimens will be considered.

In my practice, I require to see large numbers of dilated glands to diagnose simple hyperplasia, whereas if only occasional dilated glands are present, I diagnose this as disordered proliferative endometrium, especially if the patient is perimenopausal. We’re featuring millions of their reader ratings on our book pages to help you find your new favourite book.

Several common artefacts are observed in endometrial biopsy specimens, which have received scant attention in the literature.