Abstract
BackgroundThe uterine endometrial polyp (EMP) has a potential risk of developing malignant tumors especially in postmenopausal women. These malignancies include endometrial intraepithelial carcinoma (EIC).Patients and methodsEight patients with EIC in the EMP, who were postmenopausal with ages ranging from 49 to 76 years (av. 62), were cytologically reviewed in comparison with histological findings.ResultsThe endometrial cytological findings were summarized as follows: mucous and watery diathesis as a background lacking or with little necrotic inflammatory changes; micropapillary cluster formation; abrupt transition between carcinoma cells and normal cells; nuclear enlargement; high N/C ratio; and single or a few prominent nucleoli. Histologically, one case had EIC alone in the EMP; three cases had EIC with stromal invasion confined to the EMP; and four cases had EIC in the atrophic endometrium in addition to EIC in the EMP. Seven patients have taken a disease-free course after surgical resection, but one patient died 44 months following the initial diagnosis because of the massive tumor extending over her peritoneal cavity.ConclusionsEndometrial cytology may be helpful for the detection of early endometrial adenocarcinomas with serous features including EIC. Some early stage endometrial adenocarcinomas represented by EIC exceptionally take an aggressive clinical course irrespective of a lack of extrauterine lesions.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1651876760876449
Highlights
The uterine body type II cancers are histogenetically distinguished from type I cancers with a background of glandular hyperplasia which is in association with the genetic alterations represented by PTEN inactivation [1]
Tumor development of uterine body serous adenocarcinoma, categorized as the type II group, has been clarified to be linked with a putative precursor lesion designated as endometrial intraepithelial carcinoma (EIC) [2,3,4]
The endometrial polyp (EMP) including EIC with / without stromal invasion measured less than 1 cm in the great diameter in all of the patients
Summary
The uterine body type II cancers are histogenetically distinguished from type I cancers with a background of glandular hyperplasia which is in association with the genetic alterations represented by PTEN inactivation [1]. Tumor development of uterine body serous adenocarcinoma, categorized as the type II group, has been clarified to be linked with a putative precursor lesion designated as endometrial intraepithelial carcinoma (EIC) [2,3,4]. EIC has been alternatively regarded as in situ serous adenocarcinoma [5,6] and is considered to usually occur in the setting of inactive or resting endometrium and frequently involves endometrial polyp (EMP) [3]. The candidates of differential cytological diagnosis for these cases are advanced serous adenocarcinoma, clear cell adenocarcinoma, high grade endometrioid adenocarcinoma and low grade endometrioid adenocarcinoma [11]. The uterine endometrial polyp (EMP) has a potential risk of developing malignant tumors especially in postmenopausal women. These malignancies include endometrial intraepithelial carcinoma (EIC). Structure watery micropapillary watery micropapillary bloody sheet-like watery micropapillary a: average of largest diameter of tumor cells (relative value compared to normal nucleus).
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