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


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

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

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.

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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