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endometrial polyp

Wednesday 17 November 2004

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)

Portfolio

  • Endometrial polyp
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