子宫内膜息肉是否伴有不典型增生的诊断要点OA

Endometrial polyps are common benign endometrial lesions characterized by irregularly dis-tributed glands,fibrotic stroma,and thick-walled blood vessels.Although most polyps are benign,some may be associated with atypical endometrial hyperplasia(AEH)or even endometrioid carcinoma.Because endometrial polyps frequently exhibit glandular crowding,architectural irregularities,and variable cytologic changes,determi-ning whether AEH involves a polyp remains a common diagnostic challenge.We report the consultation case of a 35-year-old infertile woman who underwent hysteroscopic polypectomy for an endometrial polyp.Histologic ex-amination revealed focal glandular crowding,epithelial stratification,mild nuclear enlargement,occasional mitotic figures,and focal secretory/tubal metaplasia-like changes.However,no clonal glandular proliferation or complex glandular architecture was identified.Through a review of the morphologic features of endometrial polyps,the di-agnostic criteria for AEH,and the role of immunohistochemical biomarkers,this case highlights that the diagnosis of AEH should be based primarily on clonal proliferation and architectural complexity rather than cytologic atyp-ia alone,which is subject to considerable interobserver variability.Recognition of the normal histologic spectrum of endometrial polyps is essential to avoid both overdiagnosis and underdiagnosis of AEH and to ensure appropri-ate clinical management,particularly in women seeking fertility preservation.