Routine histologic features in complex atypical hyperplasia can predict the presence of endometrial carcinoma: a clinicopathologic study of 222 cases

There is a wide range of finding endometrial adenocarcinoma (ADCA) in the uterus following a diagnosis of complex atypical hyperplasia (CAH), likely due to a poor diagnostic reproducibility and an inherent heterogeneity in CAH. We evaluated whether histologic subtyping of CAH would help predict ADCA. Our study consisted of 222 cases of CAH diagnosed by endometrial biopsy or curettage. ADCA was seen in 38.3% of these cases at hysterectomy. We divided CAH into two subtypes: type A was defined as back-to-back glands in a focus smaller than 2.1 mm, and type B as crowded glands with cytologic atypia but there was still intervening stroma regardless of lesional size.

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