Article

Diagnosis of Endometrial Stromal Tumors A Clinicopathologic Study of 25 Biopsy Specimens With Identification of Problematic Areas

American Journal of Clinical Pathology (Impact Factor: 2.51). 01/2014; 141(1):133-9. DOI: 10.1309/AJCPXD0TPYSNVI8I
Source: PubMed

ABSTRACT

Objectives:
To assess the difficulties associated with diagnosing endometrial stromal tumors (ESTs) on endometrial biopsy.

Methods:
We examined 25 endometrial biopsy specimens from 19 consecutive women diagnosed with either endometrial stromal nodule (n = 3) or endometrial stromal sarcoma (n = 16).

Results:
Rereview of the biopsy specimens revealed a stromal fragment suspicious for an EST in 16, of which eight had received a benign diagnosis on initial review. Most ESTs had an aglandular stromal fragment that was 5 mm or larger. Stromal fragments of this size were not encountered in the control material. Problematic areas included highly cellular leiomyoma and a lack of attention to the stromal compartment.

Conclusions:
Most endometrial stromal tumors present with large aglandular stromal fragments (≥5 mm). These fragments are large enough that difficulties in diagnosis appear to be due to a lack of attention to the stromal compartment.

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    • "The 2014 WHO classification scheme incorporates recent molecular findings into the classification, dividing ESTs into endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS), and undifferentiated uterine sarcoma (UUS) [1] based on their histological appearance. However, the differentiation between the subtypes is difficult [2] [3] in specimens obtained after curettage. Furthermore, the prognosis varies from benign to invasive and malignant tumors. "
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