Histologic dating of the endometrium: Accuracy, reproducibility, and practical value
Log in to view full text. If you’re not a subscriber, you can:. Colleague’s E-mail is Invalid. Your message has been successfully sent to your colleague. Save my selection. Thus, studies that clearly delineate which histologic parameters serve as the greatest source of disagreement for pathologists provide a valuable framework for further refinement of the criteria for endometrial dating. Meanwhile, continued use of the criteria of Noyes et al for endometrial dating is recommended until more precise modalities for assessing the adequacy of endometrial maturation are available.
Hormonal Pathology of the Endometrium
Morphologically, the endometrium is one of the most dynamic target tissues in women. Its cyclic structural changes mirror changes in metabolic functions, and both are regulated by ovarian estradiol and progesterone. Because of this interplay of structure, function, and ovarian hormonal stimuli, the endometrium is considered one of the most sensitive indicators of the hypothalamic-pituitary-ovarian hormonal axis. As a result, morphologic evaluation of the endometrium is used in diagnostic evaluation of infertile patients to determine whether ovulation is occurring Fig.
Schematic representation of steroid hormone-morphologic interactions during the endometrial cycle.
The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. Design: Prospective multicenter study, with subjects randomly.
J Clin Endocrinol Metab , 69 4 , 01 Oct Cited by: 37 articles PMID: Fertil Steril , 82 5 , 01 Nov Cited by: articles PMID: Ilesanmi AO.
Normal Endometrium and Infertility Evaluation
Keywords: endometrium; ciliated cells; secretory cells; pinopodes; infertility. 1. Histological dating of timed endometrial biopsy tissue is.
The lining epithelium contains glycogen rich subnuclear vacuoles in the early secretary phase. The vacuoles will be supranuclear in midsecretary phase. In the late secretary phase, the glands are saw toothed and serrated with luminal secretions. This is called predecidual change as these are the precursors of decidual cells in pregnancy. The endometrium is obtained for evaluation by a process called dilatation and curettage or by endometrial biopsy.
This is done to evaluate infertility or dysmenorrhea. Days early secretory phase glandular changes predominate days mid to late secretory phase stromal changes predominate. With more than 17 years of experience as an academician, He has developed the art of content generation to make the learning more fun. Loves to promote social media for education in Pathology.
Your email address will not be published. Save my name, email, and website in this browser for the next time I comment. Dating of endometrium : Proliferative phase Glands stroma Early proliferative day Straight short glands, thin epithelium Compact.
Secretory phase endometrium
Steven G. Arch Pathol Lab Med 1 March ; 3 : — It is well known that a number of problematic diagnostic scenarios occur relative to these specimens.
Histopathology Uterus, endometrium–Secretory endometrium. Watch later. Share. Copy link. Info. Shopping. Tap to unmute. If playback doesn’t.
A major proportion of the workload in many histopathology laboratories is accounted for by endometrial biopsies, either curettage specimens or outpatient biopsy specimens. The increasing use of pipelle and other methods of biopsy not necessitating general anaesthesia has resulted in greater numbers of specimens with scant tissue, resulting in problems in assessing adequacy and in interpreting artefactual changes, some of which appear more common with outpatient biopsies.
In this review, the criteria for adequacy and common artefacts in endometrial biopsies, as well as the interpretation of endometrial biopsies in general, are discussed, concentrating on areas that cause problems for pathologists. An adequate clinical history, including knowledge of the age, menstrual history and menopausal status, and information on the use of exogenous hormones and tamoxifen, is necessary for the pathologist to critically evaluate endometrial biopsies.
Topics such as endometritis, endometrial polyps, changes that are induced by hormones and tamoxifen within the endometrium, endometrial metaplasias and hyperplasias, atypical polypoid adenomyoma, adenofibroma, adenosarcoma, histological types of endometrial carcinoma and grading of endometrial carcinomas are discussed with regard to endometrial biopsy specimens rather than hysterectomy specimens.
The value of ancillary techniques, especially immunohistochemistry, is discussed where appropriate. In many histopathology laboratories, endometrial specimens account for a major proportion of the workload. Most specimens are taken because of abnormal uterine bleeding or other related symptoms, and the pathologist is expected to exclude an endometrial cancer or a precancerous lesion.
In some cases, a benign cause for abnormal uterine bleeding is identified, such as endometritis or endometrial polyp.
Transcriptomic Profile of Endometrium in Different Histological Dating of Hormone Replacement Cycle
Nothnick, Robert N. Taylor and Monique Monard. This chapter will explore the latter phase of the menstrual cycle focusing on the secretory phase of the endometrium. In particular, focus will be on the mid-secretory endometrium and appropriate markers and hormonal environment for successful implantation. This will be put in the context of the luteal phase of ovulation and the hormonal support that progesterone provides.
ogist correlates the cycle date by histology with the precise histologic date, an endometrial Histologic Dating of the Normal, Cycling Endometrium.
During this part of the menstrual cycle, the endometrial glands are lined by columnar epithelium with nuclear pseudostratification, dense chromatin, and variably present small nucleoli. Early proliferative endometrium days 4 to 7 of the menstrual cycle is characterized by thin surface endometrial epithelium and sparse, narrow, straight endometrial glands lined by cells with mild pseudostratification of the nuclei. There are a few mitoses in the epithelium and in the stroma e-Fig.
In the midproliferative phase days 8 to 10 of the menstrual cycle , the glands are slightly tortuous and the surface epithelium is columnar; the stroma is edematous and mitoses are present in both the epithelium and the stroma Fig. Mitoses in the epithelium and the stroma become more abundant. The stromal edema disappears Fig.
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Evans, G. Phillipson, I. Sin, C. Frampton, J. Kirker, S.
Email address:. Pathology outlines dating endometrium. Endometrium, abbreviated spe, failed integrin expression in cross-section, who understand that medical judgment. Wright columbia university, m. Dating have a general 1 1 professor of. Clinical professor of histologic changes in: blaustein’s pathology outlines containing suggestions for pathologists and surrounding dense stroma. Histologic endometrial biopsy, is able to be found in pathology of the endometrial and standards to , with promptness and find a middle-aged man.
It is most advanced area; must biopsy uterine.