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Case 144

A 60 year old female with abnormal uterine bleeding and treated with progestin, here is the biopsy:


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  1. What's your interpretation?

    A: No residual hyperplasia

    B: No residual atypical hyperplasia

    C: Residual hyperplasia

    D: Residual atypical hyperplasia


Answer

The presence of papillary growth with abundant cytoplasm in the setting of progestin treatment, this is compatible with residual disease.


-Residual atypical hyperplasia in a background of exogenous progestin effect.


COMMENT: There are multiple small foci of papillary structures with eosinophilic epithelium, indicative of residual complex atypical hyperplasia with superimposed exogenous progestin treatment effect. Atypical hyperplasia is estimated to involve 25% of the sample.

Case credit: UCSD Pathology

Author: Wangpan Jackson Shi, MD

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