PATH: Endometrium and Myometrium Flashcards
What is a common pathological finding of endometrial hyperplasia?
high gland: stromal ratio
very little space between intervening stroma
What is a rough way to tell if you are looking at non-atypical versus atypical hyperplasia?
the cells of atypical will be much darker
If you see really abnormal endometrium with a central area of necrosis (PMNs), what should you automatically expect?
endometrial carcinoma
Who gets type I endometrial carcinoma?
55-65 yo
Who gets type II endometrial carcinoma?
65-75 yo
What is the setting of type I endometrial carcinoma?
unopposed estrogen
obesity
HTN
diabetes
What is the setting of type II endometrial carcinoma?
atrophy
thin physique
What is the morphology of type I endometrial carcinoma?
endometriod
What is the morphology of type II endometrial carcinoma?
serous or mixed mullerian tumor
What is the precursor to type I endometrial carcinoma?
hyperplasia
What is the precursor to type II endometrial carcinoma?
serous endometrial intraepithelial carcinoma
List the mutations in order for type I endometrial carcinoma.
Normal–> PTEN mutation and MLH1 mutation
Non-atypical hyperplasia–> KRAS, macrosatellite instability
Atypical hyperplasia –> ARID1A, PIK3CA, CTNNB1, FGFR2
Grade 1 uterine endometrioid carcinoma
List the mutations in order for type II endometrial carcinoma.
Atropic endometrium–> TP53 aneuploidy
Serous endometrial intraepithelial carcinoma–> FBXW7, PPP2R1A, CCNE1
What is the behavior of type I endometrial carcinoma?
indolent
How does type I endometrial carcinoma spread?
lymphatics
What is the behavior of type II endometrial carcinoma?
aggressive
How does type II endometrial carcinoma spread?
intraperitoneal and lymphatic spread
What type of microscopic pattern does type II endometrial carcinoma have?
papillary pattern
What do you think of if you see a circumscribed nodule in the myometrium?
leiomyoma
What is the microscopic pathology of a leiomyoma?
smooth muscle cells elongated and have eosinophilic cytoplasm and elongated, cigar-shaped nuclei (uniform with sparse or absent mitotic figures)
