patho quest - pepsi00

[ArchivalUser]

A 50 year old nulliparous woman with a history of diabetes complains her menustrual blood flow is more abundant than usual. During the last two menstrual cycles,she noticed spotting throughout the entire cycle. The patient is obese(BMI=32 KG) and her blood pressure is
160/100 mmHg. An ultrasound examination reveals thickened endometrial stripe with a polypoid mass in the uterine fundus. The patient undergoes a hysterectomy. The uterus is opened to reveal a partially necrotic mass/ A biopsy of the mass moderately differentiated adenocarcinoma. Which of the following represents the most likely precursor of the patient's malignant disease?

A. Adenomyosis
B.Atypcal hyperplasia
C. Chronic endometritis
D. Complex hyperplasia
E. Glandular metaplasia

Explain key points and answer
Thanks

[ArchivalUser]

bbb? I think it is the precursr of adenoca.

[ArchivalUser]

D.

[ArchivalUser]

what is the difference between B and D?

[ArchivalUser]

B

Simple hyperplasia = Increased number of cystically dilated glands
No glandular crowding

Complex hyperplasia =Increased number of dilated glands with branching
Glandular crowding

Atypical hyperplasia =Glandular crowding and dysplastic epithelium
Increased risk for endometrial cancer

[ArchivalUser]

B is correct!

Simple has more stroma
Complex has less stroma bc more glandular

[ArchivalUser]

bbb

[ArchivalUser]

B.Atypcal hyperplasia