Pdf on mar 10, 2017, laura ardighieri and others published ariasstella reaction find, read and cite all the research you need on researchgate. Polypoid endometriosis of the uterine cervix with arias stella reaction in a patient taking phytoestrogens. Since its first description more than four decades ago, the atypical endometrial change associated with chorionic tissue effect has been widely confirmed in the literature. The arias stella reaction is a hormonerelated atypical endometrial change characterized by hypertrophy and vacuolization of glandular epithelial cells, associated with marked nuclear pleomorphism, enlargement, and hyperchromasia. Benign lesions of the cervix the belgian society of. The condition is a normal physiological process of the body, caused due to hormonal response. The ariasstella phenomenon in the diagnosis of ectopic pregnancy. The endometrium exhibits a unique physiology in its ability to cyclically respond to steroid hormones, resulting in morphologic changes that allow the pathologists interpretation of proper endometrial function. The abdominal ectopic pregnancy is very rare and accounts for less than 1% of all ectopic gestations. Here, we are reporting the case of a 41yearold woman that was referred to our hospital because of severe vaginal bleeding caused by multiple uterine perforations during the. Nuclear atypia refers to abnormal appearance of cell nuclei. Histopathological changes of decidua and decidualvessels. Atypical nuclei are often pleomorphic nuclear atypia can be seen in reactive changes, preneoplastic changes and malignancy. Ariasstella reaction of uterine cervix is a benign tumorlike condition caused due to a change in the cervix.
Napsin a is a specific marker for ovarian clear cell. Vida culic, bernarda lozic, ivana kuzmicprusac, goran mijaljica, jasminka pavelic. The two patients whose examination exhibited an arias stella reaction were determined to have missed miscarriage, as both had previous ultrasounds that confirmed intrauterine pregnancies. This site was designed with the wix website builder. Division of womens and perinatal pathology department of pathology brigham and womens hospital boston. An understanding of the mechanism of enlargement of the nucleus and the unique. Ariasstella reaction in fallopian tube epithelium a light and. Ariasstella reaction of uterine corpus is a benign tumorlike condition caused due to a change in the endometrium of the uterus. Original article histopathological study of villous.
Clear cell adenocarcinoma of the uterine cervix in a 24yearold woman. Ectopic pregnancy human chorionic gonadotropin uterus. Ariasstella reaction with signet ringlike cell histomorphology. Facts and fancies four decades after since its first description more than four decades ago, the. Arias stella reaction, atypical endometrium, endometrial change. In this study, classic cc immunohistochemical markers napsin a, hnf1. Especially the arias stella reaction, we obtained endometrial specimens by either aspiration cytology, or curettage. Immunohistochemical staining for ki67 and p53 helps. The ariasstella reaction asr is a common and universally recognized feature of gestati. Immuno stains might help, in arias stella reaction er and pr are positive, and ki67 is. I found a modified ariasstella reaction in paratubal epithelial cells. Departments of gynaecology and pathology, university of glasgow.
Benign mimics of em hyperplasia artefacts endometritis endometrial polyp arias stella reaction disordered proliferative endometrium benign papillary proliferations lower uterine segment endometrium 53. It is identical in appearance to the arias stella reaction within the gravid endometrium. The purpose of this study is to describe the morphologic features observed in the decidual blood vessels of early pregnancy loss cases prior to 20 weeks gestation, and to compare these findings with arias stella reaction and with changes found in endometrial biopsies of. The endometrial glands are lined by cells with abundant clear cytoplasm. Cytologically, it looks like a malignancy and, historically, it was diagnosed as endometrial cancer. Arias stella reaction like changes in endocervical glandular epithelium in cervical smears during pregnancy and postpartum statesa potential diagnostic pitfall. Get your full text copy in pdf american journal of case. Value of histopathologic examination of uterine products. Keywords ariasstella, signet ringlike, endometrium, benign.
Full trisomy 5 in a sample of spontaneous abortion and arias stella reaction. However, the arias stella reaction is exceedingly rare in the fallopian tube, and may be confused with herpetic infection or malignancy. A case report, diagnostic cytopathology, 2005, 32, 2, 94wiley online library. An overview of gynecologic pathology is in the gynecologic pathology article. Ariasstella reaction in fallopian tube epithelium a light. Unlimited viewing of the articlechapter pdf and any associated supplements. The pap test can be difficult to analyse during pregnancy because of large ectropion, frequent inflammation, presence of confusing decidual cells that can be mistaken for atypia, also called an arias stella reaction, but has the same accuracy as in nonpregnant women. Pdf polypoid endometriosis of the uterine cervix with. Download as ppt, pdf, txt or read online from scribd. New york the purpose of this paper is to describe certain endometrial changes which occur in the presence of chorionic tissue and which, it is thought, result from the hormonal activity of this tissue. Arias stella endometrial reaction is suggestive but not diagnostic of ectopic pregnancy.
Both had a history of passing tissue and were diagnosed clinically with incomplete miscarriage. Gpc3 expression was observed almost exclusively in endometrium in the gestational state, which showed arias stella reaction. In endocervical polyp histologic features similar as in the endometrium. The glandular cells showed signs of macronucleosis and little proliferative activity measured by ki67. Pdf on mar 10, 2017, laura ardighieri and others published arias stella reaction find, read and cite all the research you need on researchgate. The endometrium is an ideal tissue for study of the interrelated effects of ovarian hormones, enzymes, and prostaglandins.
The distinction of the arias stella reaction from clear cell carcinoma of the endometrium is usually straightforward. Ariasstella reaction atypical endometriumendometrial change. Eponyms and names in obstetrics and gynaecology by thomas. The glands also show marked cytoplasmic vacuolization. When presenting in extrauterine sites, the differentiation of arias stella changes from other more ominous clear cell lesions may pose. The ariasstella reaction hyperplastic changes of the endometrial epithelium associated with cellular.
Cambridge core history of medicine eponyms and names in obstetrics and gynaecology by thomas f. Modified ariasstella reaction in paratubal epithelium. Pdf full trisomy 5 in a sample of spontaneous abortion. If the ectopic pregnancy miscarries, the uterine decidua may slough off as a cast, but more commonly as fragments mixed with small blood clots. Severe nuclear atypia is, in most cases, considered an indicator of malignancy see also.
Synthetic progestogenoestrogen therapy and uterine. Modified ariasstella reaction in paratubal epithelium springerlink. Reduced vessels per villi and hydropic change were significantly associated with abortions happening at 8 10 weeks, while reduced patency of vessels, abnormal villous contour, ghost villi and trophoblastic proliferation were more associated. Arias stella reaction is a hormoneinduced atypical. Identical changes can be seen in an ectopic pregnancy. Distinctive changes are also observed during times of physiologic hormonal changes, such as in pregnancy, or in pathologic and iatrogenic hormonal imbalances, as in certain functioning. Continuous therapy with synthetic progestogenoestrogen produces marked atrophy of endometrial glands and massive pseudodecidual stromal transformation. Article information, pdf download for ariasstella reaction with signet. Research article value of histopathologic examination of. Ariasstella reaction, also ariasstella phenomenon, is a benign change in the endometrium. Advances in the biochemistry and physiology of the uterus have stimulated reinterpretation of the cyclic morphological changes in the endometrium.
The authors present a case of arias stella reaction in the fallopian tube and discuss the. The ariasstella phenomenon was first described by javier ariasstella in 1954 as atypical endometrial changes associated with the presence of. Infiltration with glycogen as the cause of the clear appearance of epithelial cells is suggested. Due to the lack of clinical suspicion, many obstetricians confuse it with other diseases and manage it inappropriately. In order to evaluate pregnancy specific endometrial changes cytomorphologically. The ariasstella reaction in early normal pregnancyan involutional. The arias stella reaction may involve endocervical glands of pregnant women.
Identification of decidua without chorionic villi is suggestive of extra uterine pregnancy. Research article value of histopathologic examination of uterine products after firsttrimester miscarriage sharifaalialsibiani department of obstetrics and gynaecology, faculty of medicine, king abdulaziz university, p. Arias stella reaction up to 10% of gravid hysterectomy specimens. The specimens selected for evaluation were all positive for the reaction on pathology studies. A cytological evaluation of the ariasstella reaction. Most pathologists are familiar with the ariasstella reaction in the endometrium, because it is seen in approximately 25% of curettage specimens duri.
The ariasstella reaction in early normal pregnancyan involutional phenomenon. View the article pdf and any associated supplements and figures for a period of 48 hours. Endometrial hyperplasia and endometrial carcinoma are dealt with in separate articles. Stella reaction as an indication of pregnancy is examined, with special reference to the diagnosis of ectopic pregnancy. The arias stella phenomenon was first described by javier arias stella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue. The endometrium is typically biopsied because of abnormal bleeding. Scattered nuclei with a smudgy, degenerated appearance are present. The glands, which may be only partially affected, are lined by pseudostratified glandular. Typically found in the endometrium focal or in a substantial portion of the endometrium. Ariasstella reaction, also arias stella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue ariasstella reaction is due to progesterone primarily. Arias stella reaction with a hypersecretorypattern shows strati. The ariasstella reaction hyperplastic changes of the endometrial epithelium associated with cellular atypia may be seen in uterine or extrauterine pregnancies.
1275 987 1157 712 150 260 499 169 471 353 382 6 1139 670 555 576 612 398 1234 609 344 351 1204 367 360 999 551 355 1374