Difference between revisions of "Arias-Stella reaction"
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The '''Arias-Stella reaction''' is a benign change. | |||
==General== | |||
*Benign atypical endometrial changes associated with chorionic tissue.<ref name=pmid11756756>{{Cite journal | last1 = Arias-Stella | first1 = J. | title = The Arias-Stella reaction: facts and fancies four decades after. | journal = Adv Anat Pathol | volume = 9 | issue = 1 | pages = 12-23 | month = Jan | year = 2002 | doi = | PMID = 11756756 }}</ref> | |||
**May be seen in a normal pregnancy, [[hydatidiform mole]]s, others. | |||
*Historically it was diagnosed as [[endometrial cancer]]. | |||
*Usually in premenopausal women - [[pregnancy|pregnant]] or recently pregnant; however, it may be seen postmenopausal women.<ref name=pmid22885379>{{Cite journal | last1 = Offman | first1 = SL. | last2 = Longacre | first2 = TA. | title = Clear cell carcinoma of the female genital tract (not everything is as clear as it seems). | journal = Adv Anat Pathol | volume = 19 | issue = 5 | pages = 296-312 | month = Sep | year = 2012 | doi = 10.1097/PAP.0b013e31826663b1 | PMID = 22885379 }}</ref> | |||
Note: | |||
*To the novice... the nuclei look really scary, i.e. they look like cancer. | |||
==Microscopic== | |||
Features:<ref name=pmid11756756/> | |||
*Epithelial component of endometrium with large nuclei - '''key feature'''. | |||
**+/-Nuclear hyperchromasia, i.e. dark nuclei. | |||
**+/-Irregular nuclear membrane. | |||
**+/-Nuclear clearing.<ref name=Ref_DCHH236-7>{{Ref DCHH|236-7}}.</ref> | |||
**+/-[[Nuclear pseudoinclusions]]. | |||
*[[NC ratio]] is preserved.<ref name=Ref_DCHH236-7>{{Ref DCHH|236-7}}</ref> | |||
*Usually a focal change. | |||
*+/-Mitoses - uncommon. | |||
Notes: | |||
*No decidual reaction in the stroma. | |||
DDx: | |||
*[[Choriocarcinoma]]. | |||
*[[Herpes simplex virus|Herpetic]] [[endometritis]]. | |||
*[[Clear cell endometrial carcinoma]]. | |||
*[[Serous endometrial carcinoma]].<ref name=pmid20173505>{{Cite journal | last1 = Félix | first1 = A. | last2 = Nogales | first2 = FF. | last3 = Arias-Stella | first3 = J. | title = Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens. | journal = Int J Gynecol Pathol | volume = 29 | issue = 2 | pages = 185-8 | month = Mar | year = 2010 | doi = 10.1097/PGP.0b013e3181b7015e | PMID = 20173505 }}</ref> | |||
Images: | |||
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_3_-_low_mag.jpg Intermediate trophoblast reaction - low mag. (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_3_-_high_mag.jpg Intermediate trophoblast - high mag. (WC)]. | |||
===Subtypes=== | |||
There are five subtypes:<ref name=pmid11756756/> | |||
#Minimal atypia. | |||
#*Usually early gestation. | |||
#Early secretory pattern. | |||
#*Mimics secretory endometrium: cytoplasmic vacuoles, central nucleus, palisading architecture. | |||
#Secretory or hypersecretory pattern. | |||
#Regenerative, proliferative or nonsecretory pattern. | |||
#Monstrous cell pattern. | |||
==See also== | |||
*[[Gynecologic pathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Gynecologic pathology]] | |||
Latest revision as of 02:56, 30 October 2012
The Arias-Stella reaction is a benign change.
General
- Benign atypical endometrial changes associated with chorionic tissue.[1]
- May be seen in a normal pregnancy, hydatidiform moles, others.
- Historically it was diagnosed as endometrial cancer.
- Usually in premenopausal women - pregnant or recently pregnant; however, it may be seen postmenopausal women.[2]
Note:
- To the novice... the nuclei look really scary, i.e. they look like cancer.
Microscopic
Features:[1]
- Epithelial component of endometrium with large nuclei - key feature.
- +/-Nuclear hyperchromasia, i.e. dark nuclei.
- +/-Irregular nuclear membrane.
- +/-Nuclear clearing.[3]
- +/-Nuclear pseudoinclusions.
- NC ratio is preserved.[3]
- Usually a focal change.
- +/-Mitoses - uncommon.
Notes:
- No decidual reaction in the stroma.
DDx:
- Choriocarcinoma.
- Herpetic endometritis.
- Clear cell endometrial carcinoma.
- Serous endometrial carcinoma.[4]
Images:
Subtypes
There are five subtypes:[1]
- Minimal atypia.
- Usually early gestation.
- Early secretory pattern.
- Mimics secretory endometrium: cytoplasmic vacuoles, central nucleus, palisading architecture.
- Secretory or hypersecretory pattern.
- Regenerative, proliferative or nonsecretory pattern.
- Monstrous cell pattern.
See also
References
- ↑ 1.0 1.1 1.2 Arias-Stella, J. (Jan 2002). "The Arias-Stella reaction: facts and fancies four decades after.". Adv Anat Pathol 9 (1): 12-23. PMID 11756756.
- ↑ Offman, SL.; Longacre, TA. (Sep 2012). "Clear cell carcinoma of the female genital tract (not everything is as clear as it seems).". Adv Anat Pathol 19 (5): 296-312. doi:10.1097/PAP.0b013e31826663b1. PMID 22885379.
- ↑ 3.0 3.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236-7. ISBN 978-0470519035.
. Cite error: Invalid
<ref>tag; name "Ref_DCHH236-7" defined multiple times with different content - ↑ Félix, A.; Nogales, FF.; Arias-Stella, J. (Mar 2010). "Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens.". Int J Gynecol Pathol 29 (2): 185-8. doi:10.1097/PGP.0b013e3181b7015e. PMID 20173505.