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atypical polypoid adenomyoma

Monday 12 October 2020

APAM

PO

Definition : Biphasic polypoid lesion consisting of a myofibroblastic stromal component and an endometrial intraepithelial neoplasm, typically with squamous metaplasia.

Images

- Atypical polypoid adenomyoma (APAM)

Microscopy

- Benign biphasic epithelial and mesenchymal tumor
- Consists of endometrial intraepithelial neoplasm (complex architecture, varying atypia up to severe, cribriform pattern, solid irregular and papillary arrangements), separated by fascicles of bland smooth muscle and fibrous stroma
- No endometrial type stroma and no prominent stromal atypia
- Squamous morules are usually present, may have central necrosis
- Minimal mitotic activity (@<@ 3 per 10 HPF)
- No desmoplasia
- Cases with more prominent fibrous appearance may be called "atypical polypoid adenofibroma"
- May have coexisting :

- Cases with markedly complex glands and architectural complexity are designated as APA of low malignant potential (APA-LMP) (Gynecol Endocrinol 2013;29:623)

See also

- uterine polyp
- cervical polyp