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. 2022 Sep 27;12(10):2339. doi: 10.3390/diagnostics12102339

Figure 4.

Figure 4

Grade 1 endometrial EC involving ECP: case 3. (A) The endocervical curettage specimen consists of fragmented ECP tissues, fibrin, and small endocervical tissues. One of the ECP fragments (yellow arrow) shows the tumor tissue. (B) The greatest dimension of EC involving the surface of ECP measures 4 mm (green arrow). The presence of thick-walled blood vessels, fibrotic stroma, and an increased number of benign endocervical glands is characteristic of ECP. (C) The depth of invasion into the polyp stroma (green arrows) measures 0.3 mm. (D) The EC cells partially involve one endocervical gland (blue asterisk), in contrast to the other uninvolved one (purple asterisk). (E) The tumor is associated with a stromal inflammatory reaction. (F) On high-power magnification, compared with non-atypical endocervical gland (lower half), the EC cells (upper half) reveal nuclear enlargement, hyperchromasia, and loss of nuclear polarity. (G) Patchy p16 positivity rules out the possibility of human papillomavirus-associated endocervical adenocarcinoma. (H) Uniform nuclear estrogen receptor immunoreactivity with intense staining intensity supports the diagnosis of grade 1 EC. (I) Primary endometrial EC does not invade the myometrium. (J) The degree of nuclear atypia is the same as that of EC involving ECP. (K) The cervix shows no pathological abnormality. (A–F) and (I–K), Hematoxylin and eosin staining. (G–H), immunohistochemical staining using polymer method. Original magnification: (A), 2.5×; (B), 10×; (C), 40×; (D), 150×; (E), 100×; (F), 400×; (G), 100×; (H), 100×; (I), 40×; (J), 150×; (K), 4×.