Endometrial stromal nodule
From Wikipedia, the free encyclopedia
| Endometrial stromal nodule | |
|---|---|
 | |
| Endometrial stromal nodule, histology | |
| Specialty | Gynecology, Pathology |
| Symptoms | Usually asymptomatic, abnormal vaginal bleeding, pelvic mass |
| Usual onset | Reproductive to postmenopausal age |
| Duration | Chronic, benign |
| Types | Benign endometrial stromal tumor |
| Causes | Unknown; associated with hypoestrogenism, tamoxifen |
| Risk factors | None specific |
| Diagnostic method | Histopathology, immunohistochemistry (CD10+, desmin−) |
| Differential diagnosis | Leiomyoma, Endometrial stromal sarcoma |
| Treatment | Surgical excision (hysterectomy or conservative) |
| Medication | None specific; hormonal therapy rarely used |
| Prognosis | Excellent after complete excision |
| Frequency | <10% of uterine mesenchymal neoplasms |
| Deaths | None reported |
An endometrial stromal nodule is a noninfiltrative, circumscribed proliferation of endometrial stromal cells and is a benign subtype of endometrial stromal tumor.[1] The appearance of the cells is identical to normal endometrial stromal cells. This can only be differentiated from low-grade endometrial stromal sarcoma by confirming lack of infiltration.[2] These nodules are rare and typically discovered incidentally after hysterectomy, with an excellent prognosis following complete excision.[3]
Patients are usually asymptomatic or present with abnormal vaginal bleeding or a pelvic mass.[1]
Pathology
Gross description
Well-circumscribed, nonencapsulated, soft yellow-tan mass (1–12 cm) with expansile borders.[1]
Microscopic description
Microscopically, the tumor consists of monotonous proliferations of bland endometrial stromal cells resembling proliferative-phase stroma. Characteristic findings include prominent proliferative-type arterioles, collagen bands, and an expansile (non-infiltrative) border. Invasion, if present, is limited to <3 mm and <3 tongue-like protrusions. Mitotic activity is typically low (<10/10 HPF), and angiolymphatic invasion is absent.[1]
