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Atypical Endometrial Hyperplasia : Morphology

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Atypical Endometrial Hyperplasia/Endometrioid Intraepithelial Neoplasia (AEH/EIN): The glands are arranged back-to-back with little intervening stroma (gland-to-stroma ratio >1). The glandular profiles are round and tubular or have complex, stellate or irregular shapes with branching and outpouchings.

Cytologic atypia is characterized by large round or elongated nuclei with high N:C ratio, loss of nuclear polarity with irregular distribution of nuclei, and inconspicuous nucleoli. Some cases show distinct nucleoli. Mitotic activity is variably increased.

Various types of metaplasias (squamous, tubal, secretory, eosinophilic, mucinous or papillary) may be present which may complicate the interpretation of cytologic features.

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