Mucinous metaplasia to neoplastic lesions in endometrial samples with cytohistologic correlation

Mucinous metaplasia of the endometrium: current concepts

OBJECTIVES

The objective of this review was to discuss the highly variable terminology describing mucinous metaplasia of the endometrium, histologic features and characteristic findings by special stains and immunohistochemistry, differential diagnostic challenges, current treatment and prognosis.

METHODS

A review of the literature was performed on mucinous metaplasia of the endometrium.

RESULTS

Mucinous metaplasia is an uncommon type of endometrial epithelial metaplasia, often associated with hyperestrogenic states or hormone replacement therapy. Histologic findings range from simple endocervical-type mucinous epithelium to architecturally complex mucinous proliferations. Mucinous metaplasia often presents a significant diagnostic challenge in endometrial biopsies and should be differentiated from endocervical microglandular hyperplasia, and mucinous or mixed mucinous and endometrioid carcinomas. Simple mucinous metaplasia is believed to have a low risk of associated carcinoma, whereas architecturally complex cases often show invasive malignancy on subsequent biopsy.

CONCLUSIONS

Complex mucinous proliferations should be managed with dilatation and curettage and repeat biopsy within 6months, and strong consideration should be given to a hysterectomy in persistent mucinous proliferations.