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Iago - Another beautiful image of a difficult diagnosis. As you point out, diagnosing APA can be a real challenge. At first pass (at least to me) they look for all the world like a well diff adenoCa. I pointed out some things above that seem concerning for gland complexity or that have an invasive sort of feel... I wonder if you could comment?

----Comment by: PathDoc15 on 8/5/2009 5:39:50 AM Click to add this comment's arrows to the image above

APA's are typically classified as benign...but a significant number are associated with usual type adenocarcinoma and there is a high recurrence rate after polypectomy. Some experts believe that they are actually very low grade polypoid adenocarcinomas. In a hysterectomy specimen, it doesn't really matter--the patient will be cured. In biopsies or curettings, however, it is important to note the possibility of associated adenocarcinoma and/or local recurrence. I usually suggest hysterectomy if there are not other contraindications.

----Comment by: KingBent on 9/18/2009 5:11:01 AM

     

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