endometrial polyp
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Clinical synopsis
asymptomatic or associated with bleeding
associated with tamoxifen therapy for breast cancer
MAcroscopy synopsis
sessile or pedunculated mass
cystically dilated glands
multicystic cut surface
Microscopy synopsis
endometrial glands unresponsive to progesterone stimulation
may have severe atypia
fibrous stroma with spindled
fibroblast-like cells
abundant extracellular connective tissue
polypoid shape
attenuated surface endometrium on 3 sides
cystic change
proliferative glands or inactive inactive
rare atypical stromal cells
polypoid shape
surface epithelium on three sides
dense stroma
+/- fibrous stroma
large and thick-walled arteries
glands more irregular, tortuous and dilated than normal endometrial glands
’out of phase’ appearance of endometrial glands
hyperplastic endometrial glands
Physiopathology
may represent circumscribed foci of endometrial hyperplasia
Types
common endometrial polyps
- proliferative hyperplastic endometrial polyp
- atrophic endometrial polyp
- functionnal endometrial polyp
- mixed endometrial-endocervical endometrial polyp
- adenomyomatous endometrial polyp
atypical polypid adenocarcinoma
Differential diagnosis
basalis endometrium
lower uterine segment
endometrial hyperplasia (stromal cells have large vesicular nuclei and mitotic figures)