From the Department of Pathology, Emory University Hospital, Atlanta, Georgia.
Arch Pathol Lab Med. 2024 Jan 1;148(1):78-98. doi: 10.5858/arpa.2022-0280-RA.
CONTEXT.—: Clinical management of endometrial carcinoma largely depends on the morphologic parameters ascertained based on the pathologic evaluation of surgical resection specimens. However, there are numerous controversial and nonstandardized aspects of both the macroscopic and microscopic assessment of surgical specimens, including grossing, adequate sampling, diagnosis, staging, reporting, and ancillary testing.
OBJECTIVE.—: To provide a comprehensive practical review of standardized grossing, key morphologic findings for reporting and staging, and diagnostic and prognostic use of ancillary testing in endometrial carcinomas.
DATA SOURCES.—: The existing literature, recommendations of the International Society of Gynecological Pathologists, and specialty consensus guidelines.
CONCLUSIONS.—: This review article summarizes important aspects of the grossing and sampling of surgical resection specimens for microscopic examination, key morphologic parameters that are required for reporting and staging, and morphologic features and immunoprofiles helpful in the differential diagnosis of low-grade and high-grade endometrial carcinomas, as well as the current status of the molecular classification of endometrial carcinoma and human epidermal growth factor receptor 2 testing in serous carcinoma. The information presented herein can be helpful in overcoming diagnostic challenges and issues related to the pathology reporting of endometrial carcinoma to practicing anatomic pathologists.
子宫内膜癌的临床治疗在很大程度上取决于基于手术切除标本病理评估的形态学参数。然而，在手术标本的宏观和微观评估中，存在着许多有争议和不规范的方面，包括大体检查、充分取样、诊断、分期、报告和辅助检查。
提供对子宫内膜癌标准化大体检查、报告和分期的关键形态学发现、以及辅助检查的诊断和预后价值的全面实用综述。
现有文献、国际妇科病理学会的建议和专业共识指南。
本文综述了手术切除标本进行显微镜检查的大体检查和取样的重要方面、报告和分期所需的关键形态学参数，以及有助于鉴别低级别和高级别子宫内膜癌的形态学特征和免疫表型，以及子宫内膜癌的分子分类和人表皮生长因子受体 2 在浆液性癌中的检测现状。本文介绍的信息有助于克服诊断挑战和与子宫内膜癌病理报告相关的问题，为从事解剖病理学家提供帮助。
