Pathology of Endometrium: Benign Lesions, Preneoplastic Lesions and Carcinomas

  • Pranab Dey


In this chapter the salient features of various benign lesions, preneoplastic lesions and different carcinomas of uterus are discussed along with microphotographs. Both the gross and microscopic figures are included to describe the lesions. In addition to gross figures, the microphotographs of cytology and immunohistochemistry of these lesions are also provided.


Uterus Hyperplasia Endometrioid intraepithelial neoplasia Disordered proliferation endometrioid carcinoma Mucinous carcinoma Serous carcinoma Clear cell carcinoma Arias-Stella reaction Polyp Metaplasia 


  1. 1.
    Kurman RJ, Carcangiu ML, Herrington S, Young RH. WHO classification of tumours of female genital reproductive organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014.Google Scholar

Suggested Reading

  1. Ambros RA, Malfetano JH. Villoglandular adenocarcinoma of the endometrium. Am J Surg Pathol. 2000;24(1):155–6.CrossRefGoogle Scholar
  2. Baak JP, Mutter GL, Robboy S, van Diest PJ, Uyterlinde AM, Orbo A, Palazzo J, Fiane B, Løvslett K, Burger C, Voorhorst F, Verheijen RH. The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system. Cancer. 2005;103(11):2304–12.CrossRefGoogle Scholar
  3. Bhola V, Hafeez MA, Shukla CB. Tuberculous endometritis. J Indian Med Assoc. 1984;82(5):149–51.PubMedGoogle Scholar
  4. del Carmen MG, Birrer M, Schorge JO. Uterine papillary serous cancer: a review of the literature. Gynecol Oncol. 2012;127:651–61.CrossRefGoogle Scholar
  5. Gadducci A, Cosio S, Spirito N, Cionini L. Clear cell carcinoma of the endometrium: a biological and clinical enigma. Anticancer Res. 2010;30(4):1327–34.PubMedGoogle Scholar
  6. Gatius S, Matias-Guiu X. Practical issues in the diagnosis of serous carcinoma of the endometrium. Mod Pathol. 2016;29(Suppl 1):S45–58.CrossRefGoogle Scholar
  7. Hentati D, Belghith B, Kochbati L, Driss M, Maalej M. Tunis Med. 2010;88(4):230–3.PubMedGoogle Scholar
  8. Jalloul RJ, Elshaikh MA, Ali-Fehmi R, Haley MM, Yoon J, Mahan M, Munkarah AR. Mucinous adenocarcinoma of the endometrium: case series and review of the literature. Int J Gynecol Cancer. 2012;22(5):812–8.CrossRefGoogle Scholar
  9. Kaspar HG, Crum CP. The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders. Arch Pathol Lab Med. 2015;139(1):39–54.CrossRefGoogle Scholar
  10. Kendall BS, Ronnett BM, Isacson C, Cho KR, Hedrick L, Diener-West M, Kurman RJ. Reproducibility of the diagnosis of endometrial hyperplasia, atypical hyperplasia, and well-differentiated carcinoma. Am J Surg Pathol. 1998;22(8):1012–9.CrossRefGoogle Scholar
  11. Kurman RJ, Kaminski PF, Norris HJ. The behaviour of endometrial hyperplasia. Along-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56:403–12.CrossRefGoogle Scholar
  12. Kurman RJ, Norris HJ. Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well–differentiated carcinoma. Cancer. 1982;49:2547–57.CrossRefGoogle Scholar
  13. Malpica A. How to approach the many faces of endometrioid carcinoma. Mod Pathol. 2016;29(Suppl 1):S29–44.CrossRefGoogle Scholar
  14. Melhem MF, Tobon H. Mucinous adenocarcinoma of the endometrium: a clinico-pathological review of 18 cases. Int J Gynecol Pathol. 1987;6:347–55.CrossRefGoogle Scholar
  15. Michels TC. Chronic endometritis. Am Fam Physician. 1995;52(1):217–22.PubMedGoogle Scholar
  16. Mittal K, Salem A, Lo A. Diagnostic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia. Hum Pathol. 2014;45(1):98–103.CrossRefGoogle Scholar
  17. Mondal SK. Histopathologic analysis of female genital tuberculosis: a fifteen-year retrospective study of 110 cases in eastern India. Turk Patoloji Derg. 2013;29(1):41–5.PubMedGoogle Scholar
  18. Ng AB, Reagan JW, Storaasli JP, Wentz WB. Mixed adenosquamous carcinoma of the endometrium. Am J Clin Pathol. 1973;59:765–81.CrossRefGoogle Scholar
  19. Nicolae A, Preda O, Nogales FF. Endometrial metaplasias and reactive changes: a spectrum of altered differentiation. J Clin Pathol. 2011;64(2):97–106.CrossRefGoogle Scholar
  20. O’Connor KA, Holman DJ, Wood JW. Menstrual cycle variability and the perimenopause. Am J Hum Biol. 2001;13(4):465–78.CrossRefGoogle Scholar
  21. Owings RA, Quick CM. Endometrial intraepithelial neoplasia. Arch Pathol Lab Med. 2014;138(4):484–91.CrossRefGoogle Scholar
  22. Rose PG. Endometrial carcinoma. N Engl J Med. 1996;335(9):640–9. Review. Erratum in: N Engl J Med 1997 May 1;336(18):1335.CrossRefGoogle Scholar
  23. Stelloo E, Nout RA, Osse EM, Jurgenliemk-Schulz IJ, Jobsen JJ, Lutgens LC, et al. Improved risk assessment by integrating molecular and clinicopathological factors in early-stage endometrial cancer – combined analysis of PORTEC cohorts. Clin Cancer Res. 2016;22:4215–24.CrossRefGoogle Scholar
  24. Talhouk A, McAlpine JN. New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care. Gynecol Oncol Res Pract. 2016;3:14.CrossRefGoogle Scholar
  25. Tobon H, Watkins GJ. Secretory adenocarcinoma of the endometrium. Int J Gynecol Pathol. 1985;4:328–35.CrossRefGoogle Scholar
  26. Treloar AE, Boynton RE, Behn BG, Brown BW. Variation of the human menstrual cycle through reproductive life. Int J Fertil. 1967;12(1 Pt 2):77–126.PubMedGoogle Scholar
  27. Zaino RJ, Kurman RJ. Squamous differentiation in carcinoma of the endometrium: a critical appraisal of adenoacanthoma and adenosquamous carcinoma. Semin Diagn Pathol. 1988;5(2):154–71.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Pranab Dey
    • 1
  1. 1.Post Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

Personalised recommendations