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Non tumor


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 4 March 2012, last major update March 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.


● Also known as glandular and stroma breakdown
● Responsible for menstrual bleeding, with a cycle of about 28 days, throughout the fertile years of a female and for some time beyond; menstrual cycles may vary widely even in the same individual
● Common in perimenopausal women
● Regulated by matrix metalloproteinases and their inhibitors (Biochim Biophys Acta 2012;1824:146)

Micro description

● Condensation of endometrial stroma under surface endometrium with nuclear dust
● Associated with predecidualized stroma and glandular exhaustion
● Cannot assess architectural changes
● May see signet ring cells (benign) if prolonged shedding

Micro images

Shedding during menstruation

Cytology description

● May have "light green body" in condensed clusters of stromal cells, due to a platelet thrombus (Diagn Cytopathol 2012;40:204)

Electron microscopy images

Shedding during menstruation

Differential diagnosis

Proliferative endometrium: at cytolgy, round-oval nuclei predominate, slightly abnormal distribution pattern of nuclei is present
Small cell carcinoma
Well differentiated endometrioid adenocarcinoma: at cytology, round-oval nuclei predominate, overlapping nuclei with moderately abnormal distribution pattern of nuclei are found; versus shedding: small, elongated reniform nuclei, some overlapping, also a remarkable abnormal distribution pattern of nuclei (Diagn Cytopathol 2012 Jan 12 [Epub ahead of print])

End of Uterus > Non tumor > Shedding

Ref Updated: 3/2/12

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