Arias-Stella reaction in upper genital tract in pregnant and non-pregnant women: a study of 120 randomly selected cases
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
1. To study the diagnostic importance of the Arias-Stella reaction.
2. To study tubal epithelial changes in ectopic pregnancy.
3. To study the occurrence of Arias-Stella reaction in non-pregnant women receiving hormonal treatment.
A prospective study was conducted on 120 patients who underwent endometrial curettage and/or salpingectomy. The patients were divided into four groups, each comprising of 30 patients. Groups 1 and 4 included non-pregnant patients who were being evaluated for infertility and dysfunctional uterine bleeding respectively, while pregnant patients were included in Group 2 (intra-uterine abortions) and Group 3 (ectopic tubal gestation). The endometrial curettings and fallopian tube lining epithelial cells were examined for the changes described by Arias-Stella. Cases which showed the presence of the Arias-Stella reaction were further classified.
The changes of the Arias-Stella reaction in endometrial glands were observed in 80% cases of intra-uterine abortions. Secretory/hypersecretory pattern was the most commonly observed type (36.67%). The reaction was seen in 3.33% each of patients evaluated for infertility and patients on hormonal therapy with oral progestational agents for the management of dysfunctional uterine bleeding. Although uncommon, the Arias-Stella reaction was noted in the epithelium of fallopian tubes (16.67%) from patients with ectopic tubal gestation.
The findings of the present study emphasize the diagnostic importance of the Arias-Stella reaction. The changes of the reaction are a histological clue to the presumptive diagnosis of the presence of chorial tissue in cases in which the chorionic material is not found in the endometrial biopsy. The morphological features can be mistaken for malignancy if the pathologist is not aware of the patient’s pregnancy or history of hormonal intake.
- Arias-Stella J (1954) Atypical endometrial changes associated with the presence of chorionic tissue. Arch Pathol 58:112–128
- Arias-Stella J (2002) The Arias-Stella reaction: facts and fancies four decades after. Adv Anat Pathol 9:12–23 CrossRef
- Frederiksen T (1958) The Arias-Stella reaction as an aid in the diagnosis of ectopic pregnancy. Acta Obstet Gynecol Scand 37:86–96 CrossRef
- Huettner PC, Gersell DJ (1994) Arias-Stella reaction in nonpregnant women: a clinicopathologic study of nine cases. Int J Gynecol Pathol 13:241–247 CrossRef
- Oertel YC (1978) The Arias-Stella reaction revisited. Arch Pathol Lab Med 102:651–654
- Arias-Stella J (1972) Atypical endometrial changes produced by chorionic tissue. Hum Pathol 3:450–453 CrossRef
- Silverberg SG (1972) Arias-Stella phenomenon in spontaneous and therapeutic abortion. Am J Obstet Gynecol 112:777–780
- Lloyd HED, Fienberg R (1965) The Arias-Stella reaction–a nonspecific involutional phenomenon in intra as well as extrauterine pregnancy. Am J Clin Pathol 43:428–432
- Roach WR, Guderian AM, Brewer JI (1960) Endometrial gland cell atypism in the presence of trophoblast. Am J Obstet Gynecol 79:680–691
- Arias-Stella J Jr, Arias-Velasquez A, Arias-Stella J (1994) Normal and abnormal mitoses in the atypical endometrial change associated with chorionic tissue effect. Am J Surg Pathol 18:694–701 CrossRef
- McCormick CJ, Menai-Williams RA (1995) Tripolar mitotic figures occurring in an Arias-Stella reaction within an endocervical polyp. Histopathology 26:575–576 CrossRef
- Birch HW, Collins CG (1961) Atypical changes of genital epithelium associated with ectopic pregnancy. Am J Obstet Gynecol 81:1198–1208
- LaIuppa MA, Cavanagh D (1963) The endometrium in ectopic pregnancy: a study based on 35 patients treated by hysterectomy. Obstet Gynecol 21:155–164
- Azzopardi JG, Zayid I (1967) Synthetic progestogen-oestrogen therapy and uterine changes. J Clin Pathol 20:731–738
- Lui M, Boerner S (2005) Arias-Stella reaction in cervicovaginal smear of a woman undergoing infertility treatment: a case report. Diagn Cytopathol 32(2):94–96 CrossRef
- Nucci MR, Young RH (2004) Arias-Stella reaction of the endocervix: a report of 18 cases with emphasis on its varied histology and differential diagnosis. Am J Surg Pathol 28(5):608–612
- Dockerty MB, Smith RA, Symmonds RE (1959) Pseudomalignant endometrial changes induced by administration of new synthetic progestins. Proc Mayo Clin 34:321–328
- Arias-Stella reaction in upper genital tract in pregnant and non-pregnant women: a study of 120 randomly selected cases
Archives of Gynecology and Obstetrics
Volume 276, Issue 1 , pp 47-52
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Pathology, Government Medical College and Hospital, Sector 32, Chandigarh, 160030, India
- 2. Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, India