A er clinical correlation, only one unsuspected partial molar pregnancy was. Try out the html to pdf api handling of histopathology materials. Module introduction to histopathology histology and cytology 2 notes once the diagnosis is made, the slides come back to the laboratory. Ariasstella reaction as a diagnostic pitfall in a bladder biopsy with endometriosis. Content is available under attributionnoncommercialsharealike 4. Pdf on mar 10, 2017, laura ardighieri and others published ariasstella reaction find, read and cite all the research you need on researchgate. The ariasstella reaction is a hormonerelated atypical endometrial. To provide a standardized method for the appropriate filing andor retrieval of avoid being destroyed or eaten by pets. Laboratory of pathology, and the beverly hospital research foundation, beverly hospital. Minute fragments of placental tissue showed no significant findings. The characteristic histologic features of the ariasstella reaction include large cells with abundant eosinophilic or vacuolated cytoplasm, nuclear enlargement, and hyperchromasia. The ariasstella reaction is a hormonerelated atypical endometrial change characterized by hypertrophy and vacuolization of glandular epithelial cells, associated with marked nuclear pleomorphism, enlargement, and hyperchromasia. 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 two patients whose examination exhibited an ariasstella reaction were determined to have missed miscarriage, as both had previous ultrasounds that confirmed intrauterine pregnancies. The ariasstella reaction ectopic pregnancy is a dangerous. Morphologically, the presence of decidua, low nucleus to cytoplasm ratio, low mitotic activity, lack of stromal invasion, and absence of a mass lesion are all features of arias stella reaction that argue against the diagnosis of clear cell carcinoma. Research article value of histopathologic examination of. Mccormick, department of histopathology, royal berkshire hospital, craven road, reading, rg1 5an, uk. The histopathologic analysis of this lesion was compromised by the small. Arias stella reaction an important glandular change that is often seen in both intrauterine and ectopic pregnancies is the arias stella reaction. Histopathologic examination confirmed products of conception in 537 96. 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. Glandular lesions showing cytologic atypia can also be found in the context of ariasstella reaction, microglandular hyperplasia, endometriosis, and mesonephric remnants. Current concepts in cervical pathology archives of. It is a branch of pathology which deals with the study of disease in a tissue section. Apr 11, 2014 napsin a is a specific marker for ovarian clear cell adenocarcinoma. Ariasstella reaction of uterine cervix in normal pregnancy is a benign tumorlike condition caused due to a change in the cervix.
May 02, 2018 arias stella reaction of uterine cervix in normal pregnancy is a benign tumorlike condition caused due to a change in the cervix. Pseudoneoplastic glandular response of the female genital tract, first described by javier arias stella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue. Departments of gynaecology and pathology, university of glasgow. Ariasstella reaction atypical endometriumendometrial change. The ariasstella phenomenon in the diagnosis of ectopic pregnancy. He was the chairman of the pathology department of memorial hospital for. Extensive regions of necrosis in curettings causes degenerating carcinoma septic abortion infarcted polyp degenerated submucosal leiomyoma 58. Ariasstella reaction as a diagnostic pitfall in a bladder. It is an incidental finding during a microscopic examination by the pathologist. We describe a case of ariasstella reaction in a bladder endometriosis that was clinically asymptomatic and was incidentally detected as a mass lesion on ultrasound examination in a pregnant woman. The condition is a normal physiological process of the body, caused due to hormonal response. Arias stella reaction as a diagnostic pitfall in a bladder biopsy with endometriosis.
Stella reaction as an indication of pregnancy is examined, with special reference to the diagnosis of ectopic pregnancy. We describe a case of arias stella reaction in a bladder endometriosis that was clinically asymptomatic and was incidentally detected as a mass lesion on ultrasound examination in a pregnant woman. A clinical history of concurrent or recent pregnancy favours ariasstella reaction. Zika virus rtpcr was positive and sequence analyses showed 100% identity with zika virus strains isolated from brazil during 2015. Original article frequency of metaplastic change in. A prospective study was conducted on 120 patients who underwent endometrial curettage andor salpingectomy. Since its first description more than four decades ago, the atypical endometrial change associated with chorionic tissue effect has. Polypoid endometriosis of the uterine cervix with arias stella reaction in a patient taking phytoestrogens.
Other rare form of stromal metaplasia like clear cell metaplasia, cartilaginous, osseous, glial and smooth muscle can also be seen in endometrium. Cytologically, it looks like a malignancy and, historically, it was diagnosed as endometrial cancer. The difficulty with mucinous metaplasia lies in its distinction from atypical mucinous glandular. Nov 19, 2012 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. The ariasstella reaction was seen in 26, but features of degeneration were. Value of histopathologic examination of uterine products. Pseudoneoplastic glandular response of the female genital tract, first described by javier ariasstella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue. The main rationale of routine histopathologic examination of products after firsttrimester miscarriages is to detect an ectopic pregnancy or a molar pregnancy, which require further management. Samples from case 5 showed predominantly endometrial tissue with arias stella reaction. An alternative approach is to examine the products only when there is a definite indication. This is a study on histopathology of endometrium in dysfunctional uterine bleeding, undertaken in. The ariasstella phenomenon was first described by javier ariasstella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue. Benign endometrial proliferations mimicking malignancies. Dermatologists have a relatively unique opportunity to study, with ease, the clinical and pathologic correlations of disease.
Department of histopathology, royal berkshire hospital, reading, uk. Slides are filed for future reference or teachingresearch for at least. There are no clearly established risk factors for uterine ariasstella reaction in normal pregnancy and the. The glands often become hypersecretory with prominent. Benign proliferations that mimic malignancies are commonly encountered during the course of assessment of small and fragmented endometrial samples. To study the occurrence of arias stella reaction in nonpregnant women receiving hormonal treatment. The tissue undergoes a series of steps before it reaches the diagnosis. The difficulty with mucinous metaplasia lies in its distinction from atypical mucinous glandular proliferations. Arias stella reaction is due to progesterone primarily. To achieve this it is important that the tissue must be prepared in such a manner. To study tubal epithelial changes in ectopic pregnancy. Arias stellas undergraduate studies were done first at the san marcos national universitys school of science in peru from 1942 to 1944 and then at the faculty of medicine from 1945 to 1951, from which he earned his bachelors in 1951.
Ariasstella reaction is uncommonly seen in pap smears often overdiagnosed as sil, but pregnant women with atypical glandular lesions agus may have sil on subsequent biopsy acta cytol 2001. To study the occurrence of ariasstella reaction in nonpregnant women receiving hormonal treatment. The ariasstella reaction is a hormonerelated atypical endometrial change characterized by hypertrophy and vacuolization of glandular epithelial cells, associated with marked nuclear pleomorphism. The arias stella reaction occurs in the endocervix of pregnant women at a frequency that ranges between 9% and 37. Ariasstella reaction of uterus is similar to ariasstella reaction of the cervix. Glypican3 expression in clear cell adenocarcinoma of the. Ariasstella reaction, also ariasstella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue.
The major advantages of histopathology are speed, low cost and the ability to provide a presumptive identification of the infecting fungus as well as demonstrating the tissue reaction. Ariasstella reaction of uterine cervix in normal pregnancy. Although benign, endometrial epithelial metaplasias often coexist with premalignant or malignant lesions causing diagnostic confusion. Material for the study consisted of endometrial tissue obtained by dilatation and. Histopathological study of endometrium in dysfunctional uterine bleeding bhoomika dadhania1. The arias stella reaction is a hormonerelated atypical endometrial change characterized by hypertrophy and vacuolization of glandular epithelial cells, associated with marked nuclear pleomorphism. The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at a particular diagnosis. Researcharticle value of histopathologic examination of uterine products after firsttrimester miscarriage sharifaalialsibiani departmentofobstetricsandgynaecology. His doctorate was also earned from that faculty in 1959. Polypoid endometriosis of the uterine cervix with ariasstella reaction in a patient taking phytoestrogens. Ariasstella reaction an important glandular change that is often seen in both intrauterine and ectopic pregnancies is the ariasstella reaction. Napsin a is a specific marker for ovarian clear cell adenocarcinoma. The term is derived from the greek histos meaning web or tissue, and refers to the science of tissues.
Stromberg dvm, phd diplomate, acvp professor of veterinary pathology ohio state university stromberg. Mar 03, 2018 the topic uterine arias stella reaction in normal pregnancy you are seeking is a synonym, or alternative name, or is closely related to the medical condition arias stella reaction of uterine corpus in normal pregnancy. Arias stella s undergraduate studies were done first at the san marcos national universitys school of science in peru from 1942 to 1944 and then at the faculty of medicine from 1945 to 1951, from which he earned his bachelors in 1951. Arias stella reaction, also arias stella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue. Some observations on the histology of the human ovary. To study the diagnostic importance of the ariasstella reaction. Immunohistochemical testing was negative for zika virus. If the glandular lesion is large, additional and less common findings include papillae papillary adenosis, microglandular hyperplasia, particularly if the patient has taken oral contraceptives or been pregnant, ariasstella reaction, intestinal metaplasia, and varying degrees of glandular atypia.
Ariasstella reaction, also ariasstella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue ariasstella reaction is due to progesterone primarily. 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. Histopathology techniques histopathology definition. 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. Morphologically, the presence of decidua, low nucleus to cytoplasm ratio, low mitotic activity, lack of stromal invasion, and absence of a mass lesion are all features of ariasstella reaction that. To study the diagnostic importance of the arias stella reaction. Samples from case 5 showed predominantly endometrial tissue with ariasstella reaction. Infiltration with glycogen as the cause of the clear appearance of epithelial cells is suggested.
Histology page 1 histological techniques histology is the study of the cellular organization of body tissues and organs. Fixation, tissue processing, histologyand immunohistochemistry procedures for diagnosis of animal tse bse, scrapie, atypical scrapie,cwd pathology department, apha. The ariasstella reaction in early normal pregnancyan involutional. Ariasstella reaction has not been previously documented in urinary bladder endometriosis.
This change occurs between 4 and 8 weeks after implantation and is a physiologic glandular response to the presence of trophoblastic tissue. Embryology the endometrium and the myometrium are of mesodermal origin and are formed secondary to fusion of the mullerian paramesonephric ducts between the 8th and 9th postovulatory weeks. This is a study on histopathology of endometrium in dysfunctional uterine bleeding, undertaken in the department of pathology of our medical college over a period of two years from july 2010 to july 2012. Extensive regions of necrosis better microscopic evidence must be sought before making a definitive diagnosis of carcinoma 59. Both had a history of passing tissue and were diagnosed clinically with incomplete miscarriage. Arias stella reaction has not been previously documented in urinary bladder endometriosis. After the reports are sent to the surgeons either as soft copy or hard copy, the laboratory has to perform the following functions 1. If the glandular lesion is large, additional and less common findings include papillae papillary adenosis, microglandular hyperplasia, particularly if the patient has taken oral contraceptives or been pregnant, arias stella reaction, intestinal metaplasia, and varying degrees of glandular atypia. Napsin a is a specific marker for ovarian clear cell. 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. A clinical history of concurrent or recent pregnancy favours arias stella reaction.
The histopathology laboratory has a policy for retention of materials in compliance with the college of american pathologist. Histopathology unchanged in the last 150 years the technique of histopathology began around the time of the discovery of cells and when the germ theory of disease was still just a theory. Original article frequency of metaplastic change in benign. Research article value of histopathologic examination of uterine products after firsttrimester miscarriage sharifaalialsibiani. Histopathology remains one of the major tools of diagnosis in mycology20 table 3. A case report, diagnostic cytopathology, 2005, 32, 2, 94wiley online library. Physiologic and exogenous hormone effects on the endometrium.
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