Endometrial Hyperplasia and Carcinoma Diagnosis: A Modern Approach

Course overview

In this lecture, a simplified approach to the classification and diagnosis of endometrial hyperplasia is presented, one endorsed by the World Health Organization classification of tumours for almost 10 years and refined thanks to recent studies exploring the role of immunohistochemistry. The distinction between hyperplasia and carcinoma, as well as the differential diagnosis of low-grade endometrial carcinoma, is discussed. The session will end with an overview of the changes seen in endometrial hyperplasia and carcinoma due to exogenous hormonal therapy, and practical ways to report cases in this clinical context. LEARNING OBJECTIVES: After this presentation, participants will be able to: - Appraise the current classification of endometrial hyperplasia, definitions of each category and the most relevant differential diagnoses - Appraise the advantages and limitations of immunohistochemistry in the diagnosis of atypical endometrial hyperplasia/endometrial intraepithelial neoplasia - Identify the spectrum of epithelial metaplasia in the endometrium and the instances in which metaplasia is a confounder in the recognition of endometrial neoplasia - Develop a consistent approach to the differential diagnosis of low-grade endometrial carcinoma and to the reporting of endometrioid neoplasia treated with exogenous progestin