GEORGE L. MUTTER, M.D. and MARISA R. NUCCI, M.D., Brigham and Women's Hospital, Boston, Massachusetts
This course will review diagnosis of neoplastic and metaplastic lesions of the endometrium, with special emphasis on revised criteria for recognition of precancers. A rationale for functional segregation into precancerous (EIN, Endometrial Intraepithelial Neoplasia) and non-precancerous categories will be presented, based upon data from genetic, morphometric, and clinical outcome studies. Special attention will be paid to resolution of heterogenous categories of endometria formerly classified as "hyperplastic" and "metaplastic." Accurate diagnosis requires judicious handling of mimics and of potentially confounding factors (sampling errors, artifacts, and superimposed hormonal effects), which will be covered in detail. The genetic basis and morphologic presentation of independent tumorigenetic pathways for endometroid vs. papillary serous carcinomas will be presented.
A mini symposium format will integrate didactic presentation with discussion of representative patient examples in topical sessions. Clinical material will be organized to illustrate the broad variety of presentations of specific categories of disease, and be accompanied by discussions of their resulting clinical management. A syllabus will be distributed at the course to complement a publicly available supportive website (www.endometrium.org). Case examples will be available as kodachrome sets for advanced mailing. A limited number of original glass histologic sections will be deposited in the slide preview room at the meeting site for review.
This course is relevant to any pathologist engaged in the interpretation of endometrial biopsies (trainees and established pathologists).