Issues in the Differential Diagnosis of Uterine Low-grade Endometrioid Carcinoma, Including Mixed Endometrial Carcinomas: Recommendations from the International Society of Gynecological Pathologists

Joseph T Rabban; C Blake Gilks; Anais Malpica; Xavier Matias-Guiu; Khush Mittal; George L Mutter; Esther Oliva; Vinita Parkash; Brigitte M Ronnett; Paul Staats; Colin J R Stewart; W Glenn McCluggage

doi:10.1097/PGP.0000000000000512

Issues in the Differential Diagnosis of Uterine Low-grade Endometrioid Carcinoma, Including Mixed Endometrial Carcinomas: Recommendations from the International Society of Gynecological Pathologists

Int J Gynecol Pathol. 2019 Jan;38 Suppl 1(Iss 1 Suppl 1):S25-S39. doi: 10.1097/PGP.0000000000000512.

Authors

Joseph T Rabban¹, C Blake Gilks, Anais Malpica, Xavier Matias-Guiu, Khush Mittal, George L Mutter, Esther Oliva, Vinita Parkash, Brigitte M Ronnett, Paul Staats, Colin J R Stewart, W Glenn McCluggage

Affiliation

¹ Pathology Department, University of California San Francisco, San Francisco, California (J.T.R.) Department of Pathology and Laboratory Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada (C.B.G.) Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.M.) Department of Pathology, University Hospital Arnau de Vilanova and Department of Pathology, University Hospital de Bellvitge, University of Lleida, IRBLLEIDA, IDIBELL, CIBERONC, Spain (X.M.G.) Department of Pathology, New York University Langone Medical Center, New York, New York (K.M.) Department of Pathology, Brigham and Women's Hospital (G.L.M.) Pathology Department, Massachusetts General Hospital (E.O.), Boston, Massachusetts Pathology Department, Yale New Haven Hospital, New Haven, Connecticut (V.P.) Department of Pathology, Johns Hopkins Medical Institutions (B.M.R.) Department of Pathology, University of Maryland School of Medicine (P.S.), Baltimore, Maryland Department of Histopathology, King Edward Memorial Hospital and School for Women's and Infants' Health, University of Western Australia, Perth, Australia (C.J.R.S.) Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland, UK (W.G.M.).

Abstract

This article provides practical recommendations developed from the International Society of Gynecological Pathologists Endometrial Carcinoma Project to address 4 issues that may arise in the diagnosis of uterine corpus low-grade endometrioid carcinoma: (1) The distinction between atypical hyperplasia and low-grade endometrioid carcinoma. (2) The distinction between low-grade endometrioid carcinoma and serous carcinoma. (3) The distinction between corded and hyalinized or spindle cell variants of low-grade endometrioid carcinoma and carcinosarcoma. (4) The diagnostic criteria for mixed endometrial carcinomas, a rare entity that should be diagnosed only after exclusion of a spectrum of tumors including morphologic variants of endometrioid carcinoma, dedifferentiated endometrial carcinoma, carcinosarcoma, and endometrial carcinomas with ambiguous morphology.

MeSH terms

Carcinoma, Endometrioid / diagnosis*
Carcinoma, Endometrioid / pathology
Carcinosarcoma / diagnosis*
Carcinosarcoma / pathology
Diagnosis, Differential
Endometrial Neoplasms / diagnosis*
Endometrial Neoplasms / pathology
Female
Gynecology
Humans
Pathologists
Practice Guidelines as Topic
Societies, Medical
Uterine Neoplasms / diagnosis*
Uterine Neoplasms / pathology
Uterus / pathology