Excision Margins

Distances (mm) to the serosa, tubal and inferior vaginal limits.

*Requires histological confirmation by biopsy. Invasion of the rectal wall or bladder wall is pT3.

pT1a = limited to endometrium pT1a = limited to endometrium

pT1 = confined to corpus uteri pT1b = <_1/2 myometrium involved pT1c = > 1/2 myometrium involved

D = tumour distance (mm) to serosa pT1 = confined to corpus uteri pT2a = endocervical glands only pT2a = endocervical glands only

pT2b = cervical stromal invasion pT2 = into cervix but confined to uterus pT2b = cervical stromal invasion pT2 = into cervix but confined to uterus pT3a = into serosa ± adnexae ± positive peritoneal cytology pT3b = into vagina pT3b = into vagina

pT3 = beyond the uterus

Figure 24.1. Uterine carcinoma. QA|

Figure 24.2. Uterine carcinoma. |W
Figure 24.3. Uterine carcinoma: regional lymph nodes. [[W

8. OTHER PATHOLOGY

Uterus

— polyp(s), hyperplasia (simple or complex with architectural ± cyto-logical atypia), adenomyosis.

Carcinoma only rarely develops within a preexisting endometrial polyp although this is increased in tamoxifen therapy.

Twenty-five percent of untreated atypical hyperplasias progress to adenocarcinoma and up to 40% are associated with concurrent disease.

Features favouring adenocarcinoma over complex hyperplasia with cyto-logical atypia are: intraglandular epithelial bridges, intraglandular polymorphs and necrosis, cytological atypia, mitoses and stromal invasion. Criteria for stromal invasion include: a. irregularly infiltrating glands associated with a fibroblastic or desmoplastic response, and/or b. extensive papillary or confluent glandular (cribriform) growth patterns. Stromal and superficial myometrial invasion are useful in distinguishing between intraendometrial and invasive adenocarcinoma in curettage specimens.

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