Diagnosis of Endometrial Biopsies and Curettings. by Robert J. Kurman Michael T. Mazur

By Robert J. Kurman Michael T. Mazur

Provides an method of formulating a pathologic analysis from the varied array of tissue bought within the surgical pathology laboratory with an emphasis on differential analysis.

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Along with progressive decidual transformation of the stromal cells, the glands and the vessels undergo pronounced alterations. Secretory changes in the glands become more prominent with increased cytoplasmic vacuolization and augmented luminal secretions that distend the glands (Fig. 4). In addition to this hypersecretory activity, the glands become highly coiled with prominent serrations and papillary folds of epithelium projecting into the lumen. The epithelial cells become stratified. Concurrently, spiral arteries are more prominent (Fig.

Gestational endometrium. Hypersecretory pattern of endometrial glands in early pregnancy with extensive cytoplasmic vacuolization. Decidualized stroma was present in other areas of the sections. 5. Gestational endometrium. Endometrium from spontaneous abortion shows diffuse decidual reaction of stroma. The glands are dilated and lined by atrophic, indistinct epithelial cells. Therapy with high-dose progestins could induce a similar pattern. appear hypersecretory, the stroma often is not decidualized (Fig.

7) Hecht BR, Bardawil WA, Khan-Dawood FS, Dawood MY. Luteal insufficiency: Correlation between endometrial dating and integrated progesterone output in clomiphene citrateinduced cycles. Am J Obstet Gynecol 1990; 163:1986–1991. (8) Shoupe D, Mishell DRJ, Lacarra M, Lobo RA, Horenstein J, d’Ablaing G et al. Correlation of endometrial maturation with four methods of estimating day of ovulation. Obstet Gynecol 1989; 73:88–92. (9) Peters AJ, Lloyd RP, Coulam CB. Prevalence of out-of-phase endometrial biopsy specimens.

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