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
Figure 24.1. Uterine carcinoma. QA|
8. OTHER PATHOLOGY
— 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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