Uterine Pathology 1

Question 1

Describe the histologic features of proliferative endometrium.

Answer 1

• Proliferative EM
  
  • tubular glands that become increasingly coiled during the proliferative phase
  • glands and stromal ratio: low
  • polarity of basal and superficial glands, and vessels
  • pseudostratified elongated, mitotically active nuclei
    
    • “pencil thin” nuclei
  • stromal cells with scant, indistinct cytoplasm
  • small round and cellular stromal cells with frequent mitosis

Question 2

Describe the histologic features of the endometrium during the early secretory endometrium.

Answer 2

• The secretory phase is the easiest to date based on histology
• Subnuclear vacuoles supranuclear vacuoles
• Secretion starts as vacuoles disappear
• Stroma similar to proliferative phase with edema
• Mitosis evident

Question 3

Describe the histologic features of the endometrium during the mid secretory endometrium.

Answer 3

• Maximal stromal edema
• Maximal glandular secretion
• Day 22 tortuous glands

Question 4

Describe the histologic features of the endometrium during the late secretory phase.

Answer 4

• Stromal decidualization
  
  • decidualization begins around spiral arteries
  • then under surface mucosa
  • finally, the entire endometrium
• Diffuse stromal luteinization and spotting granular cells

Question 5

What are the histologic features of the menstrual endometrium?

Answer 5

• Exhausted secretory glands
• Hemorrhage and fibrin
• Stromal collapse
• Acute inflammation

Question 6

What are the histologic features of atrophic endometrium?

Answer 6

• Common cause of post-menopause bleeding
• Lack of estrogen support
• Thin layer of atrophic glands and stroma