Endometrial hyperplasia differential diagnosis: Difference between revisions

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__NOTOC__
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{{Endometrial hyperplasia}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Endometrial_hyperplasia]]
{{CMG}} {{AE}} {{Badria}} , {{STM}}
{{CMG}} {{AE}} {{Badria}} , {{STM}}



Revision as of 22:03, 28 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Badria Munir M.B.B.S.[2] , Soujanya Thummathati, MBBS [3]

Overview

Endometrial hyperplasia must be differentiated from conditions that have a similar ultrasound findings such as normal thickening during the secretory phase, sessile endometrial polyp, submucosal uterine fibroids, endometrial cancer, an adherent intrauterine blood clot, and pregnancy.

Differential Diagnosis

  • Endometrial hyperplasia must be differentiated from the following conditions that have abnormal thickening of the uterus:[1][2][3]

Pregnancy related

Non-pregnancy related

  • Endometrial carcinoma (variable appearance)
  • Endometrial polyp or polyps (usually hyperechoic, often focal, look for vascular stalk)
  • Submucosal uterine fibroids
  • Intrauterine adhesions (irregular echogenic areas with focal thickening)

Potential biomarkers

  • The absence of PAX2 expression on immunohistochemistry is helpful in delineating EIN[4][5][6][7]
  • MMP-9
  • BCL-2 overexpression

References

  1. Hulka CA, Hall DA, McCarthy K, Simeone JF (1994). "Endometrial polyps, hyperplasia, and carcinoma in postmenopausal women: differentiation with endovaginal sonography". Radiology. 191 (3): 755–8. doi:10.1148/radiology.191.3.8184058. PMID 8184058.
  2. Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 3, 2016.
  3. Abnormally thickened endometrium: differential diagnosis. Radiopedia. http://radiopaedia.org/articles/abnormally-thickened-endometrium-differential-diagnosis Accessed on March 3, 2016.
  4. Quick CM, Laury AR, Monte NM, Mutter GL (November 2012). "Utility of PAX2 as a marker for diagnosis of endometrial intraepithelial neoplasia". Am. J. Clin. Pathol. 138 (5): 678–84. doi:10.1309/AJCP8OMLT7KDWLMF. PMID 23086768.
  5. Mutter GL, Baak JP, Crum CP, Richart RM, Ferenczy A, Faquin WC (March 2000). "Endometrial precancer diagnosis by histopathology, clonal analysis, and computerized morphometry". J. Pathol. 190 (4): 462–9. doi:10.1002/(SICI)1096-9896(200003)190:4<462::AID-PATH590>3.0.CO;2-D. PMID 10699996.
  6. Allison KH, Upson K, Reed SD, Jordan CD, Newton KM, Doherty J, Swisher EM, Garcia RL (March 2012). "PAX2 loss by immunohistochemistry occurs early and often in endometrial hyperplasia". Int. J. Gynecol. Pathol. 31 (2): 151–159. doi:10.1097/PGP.0b013e318226b376. PMC 4646427. PMID 22317873.
  7. Laas E, Ballester M, Cortez A, Gonin J, Daraï E, Graesslin O (May 2014). "Supervised clustering of immunohistochemical markers to distinguish atypical endometrial hyperplasia from grade 1 endometrial cancer". Gynecol. Oncol. 133 (2): 205–10. doi:10.1016/j.ygyno.2014.02.018. PMID 24556060.

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