Endometrial Hyperplasia : Differential Diagnosis

Comments:
Endometrial Hyperplasia (EH) - Differential Diagnosis: Various metaplasias can involve both normal as well as hyperplastic/neoplastic endometrium and can complicate interpretation of endometrial biopsies. Metaplastic focus appears different from the background endometrium and can mimic neoplasia. The most common types of metaplasias include ciliary (tubal), eosinophilic (shown here), squamous, mucinous, hobnail, clear cell, and papillary syncytial metaplasia.

One should evaluate the entire endometrial specimen and establish whether or not there is metaplasia. If present, the overall topographic distribution (scattered, diffuse, local) of metaplasia should be noted. The cytologic and architectural features of metaplastic and nonmetaplastic areas are compared.

Isolated metaplasia will not show glandular overcrowding at scanning magnification. When metaplastic changes are seen geographically in a focus of crowded glands that are noticeably different than noncrowded glands, a diagnosis of atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia can be considered.