Page 752 - Textbook of Pathology, 6th Edition

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Figure 24.14 Endometrial carcinoma. A, B, Diagrammatic
representation of the common gross patterns—localised polypoid growth
and diffuse growth. C, The specimen of the uterus and cervix shows
enlarged uterus and dilated uterine cavity containing irregular, grey-white,
friable growth arising from endometrial mucosa and invading the
underlying myometrium superficially.

sometimes showing ‘back-to-back crowding’ due to G1: Well-differentiated (predominantly glandular).
obliterated intervening stroma. The glandular epithelium G2: Moderately-differentiated (glandular and partly solid
shows stratification, formation of tufting and papillae and areas).
atypical changes. Most growths are well-differentiated G3: Poorly-differentiated (predominantly solid).
(Fig. 24.15).
SECTION III
Moderately-differentiated adenocarcinoma shows all the Papillary serous carcinoma of the endometrium resembling
above features alongwith presence of some solid sheets its ovarian counterpart is distinct since it occurs in the
of malignant cells. background of atrophic endometrium and is more
Poorly-differentiated adenocarcinoma is characterised by aggressive. Uncommon histologic variants of endometrial carci-
presence of solid sheets and ribbons of malignant epithe- noma are: adenocarcinoma with squamous metaplasia
lial cells which show marked cytologic atypia and frequent (adenoacanthoma), adenosquamous carcinoma (when both
mitoses. Glandular pattern is hard to find. components are frankly malignant), clear cell carcinoma,
Cases can also be categorised as regards histologic mucinous adenocarcinoma and papillary serous carcinoma.
grade as follows: Carcinoma of the endometrium is categorised into four
stages as per FIGO classification given in Table 24.5.
Systemic Pathology

Figure 24.15 Endometrial carcinoma. The most common histologic pattern is well-differentiated adenocarcinoma showing closely packed
(back-to-back) glands with cytologic atypia.