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Kim EK, Yoon G, Kim HS. Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis. Am J Transl Res. 2016;8(5):2459-67
Kim, E. K., Yoon, G., & Kim, H. S. (2016). Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis. American journal of translational research, 8(5), 2459-67.
Kim, Eun Kyung, et al. "Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis." American journal of translational research vol. 8,5 (2016): 2459-67.
Kim EK, Yoon G, Kim HS. Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis. Am J Transl Res. 2016 May 15;8(5):2459-67. eCollection 2016. PMID: 27347355; PMCID: PMC4891460.
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Am J Transl Res. 2016 May 15;8(5):2459-67. eCollection 2016.

Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis.

American journal of translational research

Eun Kyung Kim, Gun Yoon, Hyun-Soo Kim

Affiliations

  1. Department of Pathology, Severance Hospital, Yonsei University College of Medicine Seoul, Republic of Korea.
  2. Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine Yangsan-si, Gyeongsangnam-do, Republic of Korea.

PMID: 27347355 PMCID: PMC4891460

Abstract

Chemotherapy is a common type of preoperative neoadjuvant treatment and postoperative adjuvant or palliative therapy for many different types of malignancies. Certain chemotherapeutic agents can induce bizarre epithelial atypia that mimics malignancy. Unfamiliarity with these changes could potentially cause confusion with a neoplastic or infectious process. The endometrium is one of the few sites where chemotherapy-induced epithelial atypia has not been appreciated. We identified four patients with marked cytologic atypia of the endometrial glandular epithelium from the surgical pathology files of Severance Hospital. The histopathologic features, immunostaining results and medical records of these patients were reviewed. All patients underwent hysteroscopic examination with endometrial curettage for investigation of vaginal bleeding. They had previously undergone chemotherapy for uterine cervical cancer (n=1), rectal cancer (n=2) and myelodysplastic syndrome (n=1). The chemotherapy regimens included alkylating agents (busulfan, cyclophosphamide, ifosfamide, cisplatin, and oxaliplatin), pyrimidine antagonists (capecitabine, decitabine, and 5-fluorouracil), taxanes (paclitaxel), and topoisomerase inhibitors (irinotecan and etoposide). On histopathological examination, the atypical epithelial changes included marked nuclear enlargement and pleomorphism, a degenerative-looking chromatin pattern, abundant microvacuolated cytoplasm, and preservation of the nuclear/cytoplasmic ratio. This study demonstrates that certain chemotherapeutic agents may cause bizarre, reactive atypia of the endometrial glandular epithelium. These changes should not be interpreted as neoplastic or infectious in nature. An awareness of prior exposure to cytotoxic agents and a familiarity with the nature and distribution of these bizarre alterations is essential to avoid misinterpretation of the morphologic features and prevent unnecessary treatment.

Keywords: Endometrium; chemotherapy; cytomegalovirus; epithelial atypia; malignancy

References

  1. Br J Cancer. 1993 May;67(5):1082-5 - PubMed
  2. Am J Surg Pathol. 2001 May;25(5):652-6 - PubMed
  3. Am J Surg Pathol. 2008 Mar;32(3):473-7 - PubMed
  4. Cancer. 1988 Feb 15;61(4):663-6 - PubMed
  5. Urol Int. 1993;50(1):21-6 - PubMed
  6. Cytopathology. 2002 Oct;13(5):330-2 - PubMed
  7. Hum Pathol. 1990 Feb;21(2):192-8 - PubMed
  8. Hum Pathol. 2000 Jun;31(6):678-83 - PubMed
  9. Cancer. 1978 Oct;42(4):1747-59 - PubMed
  10. Hum Pathol. 1975 Nov;6(6):693-709 - PubMed
  11. Am J Clin Pathol. 1965 Oct;44(4):385-97 - PubMed
  12. Am J Clin Pathol. 1964 Jul;42:37-44 - PubMed
  13. Histopathology. 1994 Feb;24(2):151-4 - PubMed
  14. Cancer Res. 1982 Jul;42(7):2930-7 - PubMed
  15. Cancer. 1971 May;27(5):1074-80 - PubMed
  16. J Rheumatol. 2004 Sep;31(9):1763-7 - PubMed
  17. Mod Pathol. 2001 May;14(5):389-96 - PubMed
  18. J Cutan Pathol. 2002 Nov;29(10):579-84 - PubMed
  19. Acta Cytol. 1990 Nov-Dec;34(6):885-90 - PubMed
  20. J Am Acad Dermatol. 2011 Sep;65(3):592-6 - PubMed

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