Abstract
Abstract Context.—Endometrial carcinoma of endometrioid histology is frequently preceded by endometrial hyperplasia, from which localized, premalignant lesions called endometrial intraepithelial neoplasia (EIN) emerge. Diagnostic criteria for EIN have been developed by histopathologic correlation with clinical outcome, molecular changes, and objective computerized histomorphometry. However, several benign mimics of EIN continue to cause diagnostic confusion. Objective.—To better understand the diagnostic pitfalls of EIN. Design.—An online quiz of 18 endometrial biopsies considered difficult by a gynecologic pathologist was constructed. Each case contained clinical history and at least 2 microscopic images. Answer choices included the following: (1) EIN, (2) polyp, (3) benign endometrium (proliferative, secretory, disordered, tubal metaplasia, and lower uterine segment), and (4) adenocarcinoma. Online tutorials were offered at the start, and the authors' diagnosis and clinical follow-up were provided at th...
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