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Arias-Stella reaction
Tuesday 27 April 2004
Arias-Stella’s effect, Arias-Stella’s phenomenon
WKP | PO |
Definition: Highly excretive gland epithelium due to increased gonadotropin stimulation. An endometrial gland cell abnormality consisting of hyperchromatic nuclei, which may be present in normal or ectopic pregnancy.
The Arias-Stella reaction (ASR) can mimic endometrial clear cell carcinoma (ECCC) in small biopsies, especially when drug or pregnancy history is unknown.
Synopsis
vacuolated clear cytoplasm
intraglandular tufts
hobnail cells
oxyphilic cytoplasm
delicate filiform papillae
intranuclear pseudoinclusions
cribriform intraglandular growth
superficial glands
deep glands
confluent or extensive gland involvement
Differential diagnosis
cervical clear cell carcinoma
- lack of a mass suspicious for cancer
- absence of a desmoplastic response
- lack of an infiltrative pattern
- spectrum of cytologic atypia
- low nuclear-cytoplasmic ratio
- usual lack of mitotic activity
IHC
Naspin A and HNF-1β are frequently expressed in both gestational and nongestational ASR, and ER expression is usually either reduced or loss. Interpretation of these markers in small biopsies containing atypical clear cells should be made with caution. (30608233)
See also
References
Nucci MR, Young RH. Arias-Stella Reaction of the Endocervix: A Report of 18 Cases With Emphasis on Its Varied Histology and Differential Diagnosis. Am J Surg Pathol. 2004 May;28(5):608-612. PMID: 15105648