Endometrial Hyperplasia and Carcinoma Diagnosis: A Modern Approach

 

In this lecture, a simplified approach to the classification and diagnosis of endometrial hyperplasia is presented, one endorsed by the World Health Organization classification of tumors for almost 10 years and refined thanks to recent studies exploring the role of immunohistochemistry. The distinction between hyperplasia and carcinoma, as well as the differential diagnosis of low-grade endometrial carcinoma, is discussed. The session will end with an overview of the changes seen in endometrial hyperplasia and carcinoma due to exogenous hormonal therapy, and practical ways to report cases in this clinical context.

Originally published on December 4, 2024

Lecture Presenter

Carlos E. Parra-Herran, MD

Carlos E. Parra-Herran, MD

Associate Professor of Pathology
Harvard Medical School
Pathologist
Brigham and Women's Hospital

Dr. Carlos E. Parra-Herran is an academic gynecologic pathologist at Brigham and Women’s Hospital and associate professor of Pathology at Harvard Medical School. He graduated from Universidad Nacional de Colombia and completed his residency at Jackson Memorial Hospital, followed by subspecialty training at Brigham and Women’s Hospital and Sunnybrook Health Sciences Centre. His research focuses on the morphologic and molecular characterization of gynecologic tract neoplasia, particularly epithelial lesions of the lower genital tract, mesenchymal tumors, and nonserous ovarian neoplasia. He has authored over 100 peer-reviewed journal articles (original research and reviews) and edited three reference textbooks: Gynecologic Pathology, a volume in the "Foundations in Diagnostic Pathology" series, 2nd edition, Elsevier, 2020; Gynecologic and Obstetric Pathology, an issue of Surgical Pathology Clinics, Volume 15(2), Elsevier, 2022; and "Tumors of the Cervix, Vagina, and Vulva" in Atlases of Tumor and Non-Tumor Pathology, Series 5, American Registry of Pathology, 2023. He has served as teaching faculty for regional, national, and international continuing medical education events. He is also part of the organizing team for the International Society of Gynecological Pathologists (ISGyP) Live Virtual Education program. Dr. Parra-Herran currently serves as a member of the ISGyP board of directors and the United States and Canadian Academy of Pathology (USCAP) education committee.

Objectives

After this presentation, participants will be able to:

  • Review the current classification of endometrial hyperplasia, definitions of each category and the most relevant differential diagnoses
  • Appraise the advantages and limitations of immunohistochemistry in the diagnosis of atypical endometrial hyperplasia/endometrial intraepithelial neoplasia
  • Identify the spectrum of epithelial metaplasia in the endometrium and the instances in which metaplasia is a confounder in the recognition of endometrial neoplasia
  • Develop a consistent approach to the differential diagnosis of low-grade endometrial carcinoma and to the reporting of endometrioid neoplasia treated with exogenous progestin

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories