Humpath.com - Human pathology

Home > E. Pathology by systems > Reproductive system > Female genital system > Uterus > CEH with atypia

CEH with atypia

Tuesday 17 January 2017

complex atypical hyperplasia; complex hyperplasia with atypia

Definition: In CEH with atypia, the endometrial glands are highly irregular in size and shape and show frequent outpouchings. The atypia is characterized by enlarged round nuclei, irregular chromatin distribution, and prominent nucleoli.

The morphologic features of complex hyperplasia with atypia overlap with those of well-differentiated adenocarcinoma and a distinction between the two may not always be possible on a biopsy.

When assessing atypia in an endometrial specimen, the atypical foci should be readily apparent. Surface epithelium should not be evaluated for atypia. Grading of atypia should be avoided.

Complex hyperplasia with atypia regresses in about 57% of cases and progression to adenocarcinoma occurs in about 30% of cases.

One should also keep in mind that when hysterectomy is performed shortly after endometrial biopsy or curettage, between 23% and 48% of women with complex atypical hyperplasia are found to harbor endometrial adenocarcinoma.

The endometrial glands are irregular in size and shape with branching and outpouchings. There is moderate to severe cytologic atypia.

Images

- http://www.webpathology.com/image.asp?n=6&Case=568

Differential diagnosis

- well-differentiated endometrioid adenocarcinoma (FIGO Grade 1)

See also

- endometrial hyperplasia