Download Atlas of Endometrial Histopathology by Gisela Dallenbach-Hellweg M.D., F.I.A.C., Hemming Poulsen PDF

By Gisela Dallenbach-Hellweg M.D., F.I.A.C., Hemming Poulsen M.D. (auth.)

ISBN-10: 3662033100

ISBN-13: 9783662033104

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36, 37) there is the beginning of a decrease in the general height of the endometrium, with shrinkage and collapse of the glands, while the stroma loses its edema, becomes dense, and remains well differentiated. The 13th day after ovulation {Figs. 38-40) shows extensive shrinkage in the overall height of the endometrium. The collapsed glands present a sawtoothed appearance. The predecidual stroma is now very dense. The RNA content in the glandular epithelial cells has diminished, whereas the stromal cells still contain large amounts of RNA.

Hobnail metaplasia, another rare type of metaplasia, contains hyperchromatic, but regular nuclei in a similar position as in the Arias-Stella reaction, but in proliferative or resting endometrium of postmenopausal patients. As in the Arias-Stella reaction with high p-human chorionic gonadotrophin (13HCG) levels, hobnail metaplasia is occasionally seen in patients with elevated postmenopausal gonadotrophin levels. The Arias-Stella reaction, in contrast, is not a metaplasia and will therefore be discussed later (see p.

The endocervical type of glands may occasionally be cystically dilated (Fig. 54). Morphologic Differential Diagnosis. (a) Basal endometrium: the glands of the basal layer branch more, show various degrees of proliferative changes, and their supporting stroma is more irregular since the collagen fibers anchorning the basalis to the myometrium extend in all directions, (b) endometrial atrophy: the glands of the atrophic endometrium are much smaller and their epithelial lining is flat; they are surrounded by a dense stroma of small cells devoid of distinctive fibers; (c) deficient proliferation: whereas the glands of the isthmus mucosa may be similar to those of deficient proliferation, the general height of the isthmus mucosa is much lower, and the tangential arrangement of the isthmus glands differs from the perpendicular course of the proliferating glands in deficient proliferation.

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