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endometrial papillary proliferation

Monday 10 December 2012

Papillary proliferation of the endometrium (PPE) without cytologic atypia is uncommon.

On histologic examination, PPE ranges from simple papillae with fibrovascular cores, often involving the surface of endometrial polyps, to complex intracystic proliferations. Some consider the latter to be analogous to nonatypical complex hyperplasia.

Localized and architecturally simple PPEs confined to a completely removed polyp are usually associated with a benign outcome and may be appropriately labeled as "benign papillary proliferation of the endometrium."

Lesions with architecturally complex papillae, especially when extensive, have an increased risk of concurrent or subsequent endometrial hyperplasia and carcinoma and should probably be regarded as analogous to atypical complex hyperplasia, and the term "complex papillary hyperplasia" is appropriate.

As the distinction between simple and complex PPE may be difficult in small endometrial aspirational samples, consideration for curettage should be given to ascertain whether the lesion has been completely removed.

Reference

- Papillary Proliferation of the Endometrium: A Clinicopathologic Study of 59 Cases of Simple and Complex Papillae Without Cytologic Atypia. Ip PP, Irving JA, McCluggage WG, Clement PB, Young RH. Am J Surg Pathol. 2012 Dec 1. PMID: 23211295