3.1.8: Endometrial Polyps
- Page ID
- 94917
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Endometrial polyps are abnormal growths of the endometrium that could be either sessile (a non-mobile polyp with a broad base with no stalk) or pedunculated (projecting into the uterine cavity and attached by a stalk). Histologically, they resemble the stratum basalis of the endometrium (i.e., cystically dilated glands with small muscular arteries) (Figure 3.1.24, A and B). The endometrial polyp stroma is more collagenous than the normal endometrial stroma (more cellular) (Figure 3.1.24 C). An endometrial polyp may be diagnosed in the presence of 2 of the following 3:
- Thick-walled vessels
- Collagenous stroma
- Epithelium on at least 3 sides
Endometrial polyps usually present with abnormal uterine bleeding. Although malignant transformation is rare, Endometrial carcinoma can arise in endometrial polyps (Figure 2B.44 D).
Figure 3.1.24 (A) Endometrial polyp (without atypia), with a thick-walled blood vessel in the middle - typical of endometrial polyps. Glands are regular. (B) Endometrial polyp (without atypia), with tubal metaplasia (black arrow, showing ciliated epithelium) and a thick-walled blood vessel (white arrow). The stroma is hemorrhagic in this case. (C) Myometrium (smooth muscle cells) versus endometrial stroma (more cellular) versus endometrial polyp stroma (more collagenous). (D) Endometrial adenocarcinoma arising in an endometrial polyp. These are most commonly endometrioid, in which case low-grade carcinoma is distinguished from hyperplasia with atypia by the presence of glandular crowding with endometrial stromal exclusion and significant cribriform, confluent glandular, labyrinthine, papillary/villoglandular, or non-squamous solid architecture.
Image Source: Haggstrom, Mikael. "Endometrial Intraepithelial Neoplasia". Image from Archives of Pathology & Laboratory Medicine 138, No. 4 (2014): 484–491. Distributed under the terms of the CCO license. doi.10.5858/arpa.2012-0709-RA
Glossary Terms
- Collagen
- flexible fibrous proteins that give connective tissue tensile strength
- Cystic
- relating to, formed of, or within a cyst; relating to the bladder or gall bladder
- Dilated
- expanded, enlarged, or widened normally or abnormally in all dimensions
- Pedunculated
- having, growing on, or being attached by a peduncle (narrow stalk by which a tumor or polyp is attached)
- Polyp
- growth that protrudes from a mucous membrane
- Sessile
- attached permanently or established
- Stratum Basale
- deepest layers of the epidermis
- Stroma
- tissue that forms the structure of an organ or body part
Image Acknowledgements
Haggstrom, Mikael. "Endometrial Intraepithelial Neoplasia". Image from Archives of Pathology & Laboratory Medicine 138, No. 4 (2014): 484–491. Distributed under the terms of the CCO license. doi.10.5858/arpa.2012-0709-RA