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Uterus

Non tumor

Arias-Stella reaction


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 3 October 2011, last major update September 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

See also Cervix-cytology topic

Definition
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● Hormonally induced histologic changes seen with intrauterine pregnancy, ectopic pregnancy and progesterone therapy (Adv Anat Pathol 2002;9:12, free full text)
● First described in 1954 paper by Peruvian pathologist
● Exaggerated gestational hyperplasia
● Endometrial glands are enlarged with abundant clear or eosinophilic cytoplasm and marked nuclear changes (large, hyperchromatic, pleomorphic and smudged) with rare mitotic figures
● Decidualized stroma
● Changes usually focal, may occur in cervix, endocervical polyps, adenomyosis (Acta Obstet Gynecol Scand 2007;86:106), endometriosis (Int J Gynecol Pathol 2010;29:185), post-abortion curettings (20-70%), pregnancies, moles and choriocarcinoma (endometrial nuclei may be gigantic in moles and choriocarcinoma)
● May provide initial information of ectopic pregnancy (Arch Gynecol Obstet 2007;276:47)

Micro images
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Various images

Negative stains
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● Ki-67 (low), p53

Differential diagnosis
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Clear cell carcinoma: post-menopausal so not pregnant, mitotic figures, coarsely granular chromatin and no decidual reaction unless patient on progesterone, p53+, Ki-67+ (Int J Gynecol Pathol 2004;23:223)
Endometrial carcinoma

End of Uterus > Non tumor > Arias-Stella reaction


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