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Abdominal Ectopic Pregnancy
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
In addition, uterine dilation and curettage can be performed, and the final pathology may show an absence of trophoblastic tissue. The pathologic evaluation of the endometrial specimen may show localized hyperplasia of endometrial glands that are secretory, which is called an Arias-Stella reaction. Aris-Stella reaction is commonly seen in ectopic pregnancies.
Immunology of pre-eclampsia
Published in Pankaj Desai, Pre-eclampsia, 2020
This concept of crosstalk came originally from animal experiments. The endometrial gland cells display the same array of endocrine receptors as are expressed in animal species, and pathologists have long recognised the hypersecretory phenotype that the glands adopt early in pregnancy, the so-called Arias-Stella reaction. Lower levels of glycoproteins secreted by the glands, such as glycodelin-A, have been linked to miscarriage because in 70% of cases, formation of the trophoblastic shell is incomplete.2 Furthermore, microarray analysis of chorionic villus samples from patients that went on to develop pre-eclampsia show aberrant expression of decidual, rather than placental, genes.15 It is indeed possible that the defective dialogue leads to defective placentation and, subsequently, to the development of pre-eclampsia.
Benign tumors and tumor-like conditions, including metaplasia
Published in T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng, Richard Wing-Cheuk Wong, Hao Chen, Diagnostic Endometrial Pathology, 2019
T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng
Clear-cell metaplasia refers to epithelial cells with clear cytoplasm rich in glycogen and cytologically bland nuclei in the nongestational endometrium.54,55 This is very uncommon but some cases may be associated with tamoxifen usage.54 The differential diagnosis may include Arias-Stella reaction and clear-cell carcinoma,54 which could usually be resolved by finding their respective histologic features.
Early Pregnancy Losses: Review of Nomenclature, Histopathology, and Possible Etiologies
Published in Fetal and Pediatric Pathology, 2018
M. Halit Pinar, Karen Gibbins, Mai He, Stefan Kostadinov, Robert Silver
The primary pathology associated with ectopic gestation is the presence of uterine decidualization without any chorionic villi or implantation site. A patient with an ectopic pregnancy may pass a decidual cast, a collection of blood and endometrial lining with secretory changes due to hormonal influences. An endometrial biopsy can demonstrate the Arias–Stella reaction, a benign change of the endometrium in response to pregnancy that is associated with stroma decidualization and a hypersecretory gland pattern (20). This reaction was supposed to be pathognomonic for an extrauterine pregnancy, but it can be seen in intrauterine pregnancies too. These findings are not useful in determining the location of the pregnancy but serve as a warning that a pregnancy is present somewhere. Thereafter, if no pregnancy is found in the uterus, a careful search for a possible ectopic pregnancy must be made.