Home > E. Pathology by systems > Reproductive system > Female genital system > Uterus > atypical polypoid adenomyoma
atypical polypoid adenomyoma
Monday 12 October 2020
APAM
| PO |
Definition : Biphasic polypoid lesion consisting of a myofibroblastic stromal component and an endometrial intraepithelial neoplasm, typically with squamous metaplasia.
Images
Atypical polypoid adenomyoma (APAM)
- https://twitter.com/Patholwalker/status/1315580962948837377
- https://twitter.com/Patholwalker/status/1443134276019445760
Microscopy
Benign biphasic epithelial and mesenchymal tumor
Consists of endometrial intraepithelial neoplasm (complex architecture, varying atypia up to severe, cribriform pattern, solid irregular and papillary arrangements), separated by fascicles of bland smooth muscle and fibrous stroma
No endometrial type stroma and no prominent stromal atypia
Squamous morules are usually present, may have central necrosis
Minimal mitotic activity (@<@ 3 per 10 HPF)
No desmoplasia
Cases with more prominent fibrous appearance may be called "atypical polypoid adenofibroma"
May have coexisting :
- EIN / complex atypical hyperplasia (Diagn Cytopathol 2010;38:527)
- well differentiated endometrioid adenocarcinoma (Kobe J Med Sci 2014;60:E74, Gynecol Oncol Case Rep 2012;2:29)
Cases with markedly complex glands and architectural complexity are designated as APA of low malignant potential (APA-LMP) (Gynecol Endocrinol 2013;29:623)
See also
uterine polyp
cervical polyp
