Case 143

A 75-year-old female with a past medical history of abnormal uterine bleeding and a prior biopsy of atypical hyperplasia with atypical mucinous glandular proliferation. Now she was treated with progestin and here is the follow-up biopsy:

1. How would you sign out this case?

A: No evidence of residual hyperplasia

B: No evidence of residual atypical hyperplasia

C: Residual hyperplasia

D: Residual atypical hyperplasia

E: Residual atypical mucinous proliferation

Answer

The case is regarded to have residual disease.

-Minimal residual atypical endometrial hyperplasia with mucinous differentiation, see comment.

COMMENT: Biopsy shows atypical endometrial glands with mucinous differentiation and cytological demarcation in the background polypoid inactive endometrium. The amount of these atypical glands represents 5% of the specimen. The clinical history of similar findings was noted.

Case credit: UCSD Pathology

Author: Wangpan Jackson Shi, MD