Premalignant and Early Invasive Lesions of the Endometrium: Case Presentations in the Light of Current Classifications

Meltem Turk Alkan; Havva Erdem; Orhan Canak

doi:10.56941/odutip.1787102

Premalignant and Early Invasive Lesions of the Endometrium: Case Presentations in the Light of Current Classifications

Authors : Meltem Turk Alkan, Havva Erdem, Orhan Canak

Pages : 130-137

Doi:10.56941/odutip.1787102

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Publication Date : 2025-12-31

Article Type : Other Papers

Abstract :Accurate classification of premalignant and early invasive lesions of the endometrium is of critical importance for the prevention of endometrial carcinoma and for the development of effective treatment strategies. The 2020 World Health Organization (WHO) classification offers an up-to-date framework for the terminology and diagnostic criteria of these lesions. In this context, we evaluated the diagnostic processes and differential criteria of three distinct endometrial lesion cases based on their morphological and immunohistochemical features. Three cases diagnosed in our pathology clinic were retrospectively analyzed. These included non-atypical endometrial hyperplasia, endometrial intraepithelial neoplasia (EIN), and FIGO Grade 1 endometrioid adenocarcinoma. All cases were histologically examined on hematoxylin and eosin (H&E)-stained sections, and immunohistochemical markers (PAX2, p53, p16, ER, PR, vimentin) were used to support the differential diagnosis. In the first case, benign morphology, preserved gland-to-stroma ratio, and absence of cytologic atypia were observed, supporting a diagnosis of endometrial hyperplasia without atypia. The second case exhibited focal glandular crowding, cytologic atypia, and loss of PAX2 expression, consistent with EIN. In the third case, pronounced nuclear atypia, cribriform glandular architecture, and increased proliferative activity supported a diagnosis of FIGO Grade 1 endometrioid adenocarcinoma. The findings suggest that the combined use of morphological assessment and immunohistochemical analysis enhances diagnostic accuracy in evaluating endometrial lesions. The WHO 2020 classification reinforces this multifaceted approach, enabling the early recognition of precancerous lesions and guiding appropriate therapeutic strategies.
Keywords : Endometrial hiperplazi, Endometrial intraepitelyal neoplazi, Endometrioid adenokarsinom, İmmünohistokimya, WHO 2020 sınıflandırması

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