EIN – The Final "Word" in Pre-Malignant Endometrioid Neoplasia

Endometrial intraepithelial neoplasia (EIN) is a monoclonal premalignant endometrial glandular lesion that precedes the development of endometrioid-type endometrial adenocarcinoma. EIN arises through complex interactions involving the sequential accumulation of genetic damage in endometrial glands and the positive selective pressure of unopposed estrogen. EIN is associated with a 45-fold increased risk of developing endometrial adenocarcinoma. In 2015, the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology sanctioned EIN as the preferred diagnostic schema (over the WHO 1994 hyperplasia classification system) for diagnosing premalignant endometrial lesions.

Lecture Presenter
Elke Jarboe, MD
Elke Jarboe, MD
Associate Professor, Pathology and Adjunct Associate Professor, Obstetrics and Gynecology, University of Utah Health Sciences Center
Medical Director, Surgical Pathology and Cytopathology, ARUP Laboratories

Dr. Jarboe is a tenured associate professor of pathology at the University of Utah School of Medicine. She received her MD from and completed her anatomic pathology residency training at the University of Colorado School of Medicine. Subsequently, she completed fellowships in women’s and perinatal pathology and cytopathology at Brigham and Women’s Hospital in Boston. Her primary subspecialty and research interest is in gynecologic pathology. Dr. Jarboe is a member of the editorial board for the International Journal of Gynecological Pathology and the cytopathology section editor for the American Journal of Clinical Pathology.

Objectives

After this presentation, participants will be able to:

To distinguish the WHO 1994 classification scheme from the WHO 2014 classification scheme for diagnosing premalignant endometrial lesions, and compare/contrast both the EIN system.
To understand why the EIN system is superior to WHO 1994 scheme for identifying clinically significant endometrial glandular lesions.
To successfully apply the criteria for diagnosing EIN, and recognize some common diagnostic pitfalls.