=============

Normal and Nearly Normal:

-- No diagnostic abnormality.   

-- No endometritis, endometrial hyperplasia or carcinoma.    

-- Mid secretory phase endometrium, day 19-20 (post ovulatory day 5-6).    

Non-Neoplastic:   

-- Benign endometrial polyp, fragments.    

-- Focal change suggestive of an endometrial polyp or submucosal leiomyoma.    

-- Diffuse stromal decidualization and glandular atrophy, consistent with exaggerated progesterone-like effect.    

-- Chronic endometritis and associated glandular crowding (see comment).   

-- Immature chorionic villi (products of conception), decidua and gestational endometrium.   

Hyperplasia:   

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.   

-- Dx text (i.e. this section):  font = 05BodyT (i.e. Normal); Style = 05 DxBodyS.   

Neoplastic:   

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.   

-- Dx text (i.e. this section):  font = 05BodyT (i.e. Normal); Style = 05 DxBodyS.   

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Benign proliferative endometrium.

-- No endometritis, endometrial polyp or endometrial hyperplasia.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Benign inter-phase endometrium.

-- No endometritis, endometrial polyp or endometrial hyperplasia.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Atrophic and inactive endometrium with focal tubal metaplasia.

-- Cervical superficial squamous epithelium.

-- No endometrial hyperplasia, squamous intraepithelial lesion or malignancy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Inactive endometrium with extensive tubal metaplasia.  

-- Small fragment of organizing fibrin clot.

-- No  atypical hyperplasia or malignancy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario: 57-yo woman .       

Endometrium, curettage:   

-- A few strips of atrophic and inactive superficial endometrial glandular epithelium.

-- Scant unremarkable endocervical glandular epithelium.

-- No glandular dysplasia or carcinoma identified in this biopsy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Secretory endometrium, date in menstrual cycle cannot be assigned.

-- No endometritis, endometrial hyperplasia or carcinoma.

-- No endocervical component is present in this biopsy (see note).

Note: 02958203.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Predominantly blood (75%), and fragments of break-down endometrium

-- No endometrial hyperplasia or malignancy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Non-menstrual breakdown endometrium and blood/fibrin clot.

-- No endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Proliferative endometrium with focal non-menstrual breakdown.

-- No endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Disordered proliferative endometrium with focal (non-menstrual) breakdown.

-- No endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Diffuse stromal decidualization and glandular atrophy, consistent with exaggerated progesterone-like effect. 

-- No endometritis, endometrial hyperplasia or malignancy detected.

Note:  Differential diagnosis may include exogenous hormonal therapy, persistent corpus luteum or a luteinized unruptured follicles, and, much less likely in this case, pregnancy.  Clinical correlation is recommended.

Slides examined:   H&E   x  X

CPT code:        8830X x  X

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Benign endometrial polyp.

-- Dyssynchronous endometrium.

-- No endometritis, endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

Editor's comment:

Endometrial polyp can harbor malignancy (e.g., foci of serous carcinoma). Thus, "benign" is used to indicate its nature. In the presence of a polyp, endometrial dating often becomes unreliable.

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Secretory endometrium, day 19-20 (post ovulatory day 5-6).

-- Focal changes suggestive but not diagnostic of benign endometrial polyp.

-- No endometritis, endometrial hyperplasia or malignancy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Focal changes suggestive but not diagnostic of a benign endometrial polyp.

-- Proliferative endometrium.

-- No endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Inactive endometrium with (non-menstral) stromal breakdown.  

-- Benign endometrial polyp.  

-- No  endometrial hyperplasia or malignancy.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Atypical polypoid adenomyoma (see Note).

-- Secretory phase endometrium.

-- No definite endometrial hyperplasia or malignancy.

Note: Sections show polypoid fragments composed of hyperplastic glands with squamous metaplasia (squamous morules) arranged haphazardly within fibromuscular stroma. The histologic features are most consistent with atypical polypoid adenomyoma although distinction from invasive endometrial adenocarcinoma can sometimes be extremely difficult.

Atypical polypoid adenomyoma is considered a benign tumor with a significant risk of recurrence if inadequately removed initially, and a very low risk of malignant transformation. Conservative treatment with preservation of chid bearing potential was often considered appropriate (ref.). A clinical follow-up in six months may be prudent

Reference: Anderson CM et al.: Endometrial tumors with a stromal component. In: Pathology of the Female Reproductive Tract. p380-382, 2002. Ed. Robboy et al. Chrchill Livingstone.

Slides examined:   H&E   x  X

CPT code:        8830X x  X

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Mid secretory phase endometrium, day 19-20 (post ovulatory day 5-6).

-- Focal change suggestive of an endometrial polyp or submucosal leiomyoma.

-- Unremarkable fragment of squamous epithelium.

-- No endometrial hyperplasia or carcinoma.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Chronic endometritis and associated glandular crowding (see comment).

-- No atypical hyperplasia or carcinoma identified

Note: Although the glandular crowding resembles complex hyperplasia, the change is focal and closely associated with chronic endometritis.  Since the change can be seen as a reactive process to inflammation and in true endometrial hyperplasia, re-biopsy after the inflammation abates is recommended.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Proliferative endometrium with focal glandular crowding (see Note).

-- Chronic endometritis (associated with the crowded glands).

-- No carcinoma.

Note:  Associated with focal glandular crowding are easily identifiable plasma cells consistent with  chronic endometritis. Occasionally, an exuberant proliferation of the endometrial glands can be seen as a secondary response to chronic endometritis.  Without the chronic endometritis, the finding of the crowded glands would suggest complexed endometrial hyperplasia with atypia.  Treatment of chronic endometritis, followed by resampling of the endometrium would likely be informative in distinguishing a primary or secondary cause of the observed glandular proliferation.

Slides examined:   H&E   x  1

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  43-yo woman. Hx/ atypical hyperplasia.       

Endometrium, curettage:     

-- Atypical complex hyperplasia and focal endometrial adenocarcinoma with hormonal treatment effects .

=============

Clinical scenario:  47-yo woman. Hx/  hyperplasia.       

Endometrium, curettage:     

-- Complex endometrial hyperplasia without atypia.

-- Squamous morules are present.

-- No carcinoma is identified.

Slides examined:   H&E   x  3

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Endometrioid adenocarcinoma, FIGO grade 1, constituting at least 75% of the specimen, arising in complex atypical endometrial hyperplasia.

-- Stromal invasion cannot be evaluated with this biopsy.

Slides examined:   H&E   x  X

CPT code:        8830X x  X

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Endometrioid adenocarcinoma with mucinous differentiation, FIGO grade 2, at least 8 mm measured on slides.

-- No definite myometrial invasion / Cannot evaluate stromal invasion with this biopsy. 

=============

Clinical scenario:  .       

Endometrium, curettage:     

-- Foci of endometrioid adenocarcinoma, FIGO grade 1, 4 mm in greatest dimension on slide, arising in background of extensive atypical complex endometrial hyperplasia.

-- No hormonal treatment effect.

=============

Clinical scenario:  42-year old with fibroids.       

Uterine corpus, laparoscopic myomectomy: 

-- Cellular leiomyoma with extensive hyalinized degenerative changes.

-- No malignancy is identified.

-- No cervical or endometrial component is present in this specimen.

Slides examined:   H&E   x  8

CPT code:        88307 x  1

=============

Clinical scenario:  44-year old with fibroid and heavy menstrual bleeding.       

Uterus, bilateral fallopian tubes and ovaries, hysterectomy and salpingo-oophorectomy:    

Uterine corpus:

     -- Multiple leiomyomas, __ - __ cm.

     -- Mild adenomyosis. 

     -- Benign weakly proliferative endometrium.

     -- No adenomyosis, endometrial hyperplasia or malignancy.

Uterine cervix:

     -- Multiple small nabothian cysts.

     -- Mild reactive changes in endocervix.

     -- No viral cytopathic change or dysplasia.

Bilateral fallopian tubes:

     -- No diagnostic abnormality.

Bilateral ovaries:

     -- Cystic follicles, bilateral.

     -- A small corpus luteum, right ovary

     -- No borderline neoplasm or malignancy.

Slides examined:   H&E   x  12

CPT code:        88307 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  45-year old with pelvic pain.       

Uterus and bilateral fallopian tubes, hysterectomy and salpingectomy:       

Uterine corpus:

     -- Moderate to severe adenomyosis

     -- Weakly proliferative endometrium.

     -- No endometrial hyperplasia or malignancy.

Uterine cervix:

     -- Multiple small nabothian cysts

     -- Mild reactive changes in endocervix

     -- No viral cytopathic change or dysplasia.

Fallopian tubes:

     -- No diagnostic abnormality.

Slides examined:   H&E   x  8

CPT code:        88307 x  1

=============

Clinical scenario:  .       

Organ, site, surgical procedure:     

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.

--

Note: 02958203.

Slides examined:   H&E   x  X

CPT code:        8830X x  X

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Organ, site, surgical procedure:     

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.

--

Note: 02958203.

Slides examined:   H&E   x  2

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Organ, site, surgical procedure:     

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.

--

Note: 02958203.

Slides examined:   H&E   x  2

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Organ, site, surgical procedure:     

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.

--

Note: 02958203.

Slides examined:   H&E   x  2

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.    

=============

Clinical scenario:  .       

Organ, site, surgical procedure:     

-- Dx Heading above font = 04Heading; Style = 04DxHeadings.

--

Note: 02958203.

Slides examined:   H&E   x  2

CPT code:        88305 x  1

Editor's comment:

This section critics on the pro & con of the the wording. There will be 12-pt space after text paragraph.