| • The neoplastic glands are crowded.
• The epithelium contains scattered neutrophils.
• The nuclei ahve chromatin clumping and clearing.
• Nucleoli are visible.
• The N:C is increased.
• The cells are not oriented to the lumen. |
| • The neoplastic glands are crowded.
• The epithelium contains scattered neutrophils.
• The nuclei ahve chromatin clumping and clearing.
• Nucleoli are visible.
• The N:C is increased.
• The cells are not oriented to the lumen. |
| Adenocarcinoma |
| Etiology |
•associated with unopposed estrogen use •may be exogenous (non-cycled estrogens) but generally •endogenous due to peripheral aromatization of adrenal
androgens by adipose in obese women •also associated with granulosa cell tumors and other estrogen producing ovarian tumors as well as polycystic ovary
syndrome •small group of women with high grade neoplasms lack
evidence of hyperestrinism |
| Pathogenesis |
•estrogen drives continued proliferation
with eventual
acquisition of somatic mutations •in the absence of progesterone maturation of the endometrium
and spiral arteries never occurs, nor does regular menses |
| Epidemiology |
•obese post-menopausal women •may also have diabetes and hypertension (classic triad) •small group of women with high grade neoplasms lacks
these correlates •increasing incidence with aging population •not reliably detected on pap smear |
| Clinical |
•post-menopausal bleeding is usual symptom;
other
symptoms rare and may indicate advanced disease •most patients are Stage I (confined to endometrium) at
diagnosis and respond completely to hysterectomy •neoplasm spreads to cervix, deep into myometrium, to ovary,
regional lymph nodes and then to distant sites •if death occurs from disease it is usually due to local disease in
the pelvis •For more information consult NCI web site |
| General Gross Description |
•fungating,
friable, tan mass with irregular infiltration
of underlying myometrium |
| General Micro Description |
•glands exhibit crowding so that they are
"back-to-back" •stratified nuclei with mitotic activity •cells lose orientation to the lumen •nucleoli become prominent, nuclei are vesicular •lumenal necrosis •if >90% glandular grade 1, 10-90% glandular grade 2,
<10% glandular grade 3 |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1060-6
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