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 characterized by enlarged glands with abundant clear or eosinophilic cytoplasm and vacuolization associated with hyperchromatic. The arias stella reaction asr can mimic endometrial clear cell carcinoma eccc in small biopsies, especially when drug or pregnancy history is unknown. Benign endometrial proliferations mimicking malignancies. Modified ariasstella reaction in paratubal epithelium. Ariasstella reaction, also ariasstella phenomenon, is a benign change in the endometrium. Pdf significance of agus pap smears in pregnant and. Napsin a is a specific marker for ovarian clear cell. The same problem was encountered by cariani and guderian 39 and mccormick and menaciwilliams 40 in endocervical polyps with ariasstella reaction. In an ectopic pregnancy, the uterine endometrium usually responds to the hormonal changes of pregnancy and undergoes focal decidua changes arias stella reaction. The difficulty with mucinous metaplasia lies in its distinction from atypical mucinous glandular.
I am analyzing themogravimetric data tga to determine kinetic parameters of thermal reaction of oil using coats and redfern method. 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. Arias is listed in the worlds largest and most authoritative dictionary database of abbreviations and acronyms arias what does arias stand for. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to. Er showed a significant difference only between arias stella reaction and clear cell carcinoma. The authors present a case of arias stella reaction in the fallopian tube and discuss the. 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. If the ectopic pregnancy miscarries, the uterine decidua may slough off as a cast, but more commonly as fragments mixed with small blood clots. Significance of agus pap smears in pregnant and postpartum women. The ariasstella phenomenon was first described by javier ariasstella in 1954 as atypical endometrial changes associated with the presence of. Studies of hormonal levels obtained from the endocrinologic literature demonstrated declines during early pregnancy at the time of the ovaryplacenta changeover. Ariasstella reaction in fallopian tube epithelium a light.
How can ariasstella reaction of uterine cervix be prevented. It can also refer to changes occurring in the cervix. Arias stella reaction in endocervix tubal metaplasia of endocervix. Decidual cells are large with ample cytoplasm, distinct cell borders and small, rounded nuclei figure 6. Calculation of kinetic parameters from thermogravimetric data. Ariasstella found that a reaction previously thought of as a cancer in the endometrium was rather a normal reactions of hormones from placental tissue. Full trisomy 5 in a sample of spontaneous abortion and arias stella reaction. Benign lesions of the cervix the belgian society of. The pap test richard mac demay, md professor of pathology director of cytopathology university of chicago ascp press american society for clinical pathology. Problem the presence of immunosuppressive cells within the endometrium and decidua is crucial for establishing maternal immune tolerance against fetal antigens. Gestational trophoblastic disease abbreviated gtd, also gestational trophoblastic neoplasia abbreviated gtn, includes choriocarcinoma and hydatidiform moles. 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 arias stella reaction was seen in 26, but features of degeneration were found in arias stella reaction nuclei as well as focal decidual necrosis. Although benign, endometrial epithelial metaplasias often coexist with premalignant or malignant lesions causing diagnostic confusion. Arias stella reaction like changes in endocervical glandular epithelium in cervical smears during pregnancy and postpartum statesa potential diagnostic pitfall authors j. Pdf full trisomy 5 in a sample of spontaneous abortion. Napsin a is a specific marker for ovarian clear cell adenocarcinoma. The ariasstella reaction is a hormonerelated atypical endometrial change characterized by hypertrophy and vacuolization of glandular epithelial cells, associated with marked nuclear pleomorphism. Expression of ki67, bcl2 and bax in the first trimester. Arias stella reaction and chorionic villi or only decidua showing arias stella reaction were included in the study. Departments of gynaecology and pathology, university of glasgow. Benign proliferations that mimic malignancies are commonly encountered during the course of assessment of small and fragmented endometrial samples. Extensive regions of necrosis in curettings causes degenerating carcinoma septic abortion infarcted polyp degenerated submucosal leiomyoma 58.
However, arias stella reaction can be present in the endometrium following a spontaneous abortion. During pregnancy, regular prenatal checkups are necessary to monitor the health of the expectant mother and baby in the womb. Ariasstella reaction of uterine corpus is a benign tumorlike condition caused due to a change in the endometrium of the uterus. Identical changes can be seen in an ectopic pregnancy. Arias stella reaction lymphoma like lesion 9 benign hyperplasia classification of precancerous lesions of the uterine corpus who 1994 nonatypical hyperplasia simple complex atypical hyperplasia simple complex type i endometrial adenocarcinoma who 2014 benign hyperplasia ein. Coexistence of endometriotic cyst of the ovary and ariasstella. The arias stella phenomenon was first described by javier arias stella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue. Norwegian fjord periphery, circumferential or multifocal trophoblastic proliferation, fetal parts. Endometrial adenocarcinoma in spontaneous abortion 8231 int j clin exp med 2015.
Atypical squamous cellsundetermined significance asc. Ki67 and p53 immunostaining was significantly less in arias stella reaction than in clear cell carcinoma p 0. Arias stella reaction the cervix undergoes both glandular and stromal changes during pregnancy similar to those occurring in the endometrium. View the article pdf and any associated supplements and figures for a period of 48 hours.
Arias stella reaction,23,23,383 arsenic,319 arthritis. The ariasstella reaction hyperplastic changes of the endometrial epithelium associated with cellular atypia may be seen in uterine or extrauterine pregnancies. Case report endometrial adenocarcinoma in spontaneous. The ariasstella reaction in early normal pregnancyan. Ariasstella reaction atypical endometriumendometrial change. Arias stella reaction, also arias stella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue arias stella reaction is due to progesterone primarily. His doctorate was also earned from that faculty in 1959. Ariasstella reaction of uterine cervix during pregnancy is a normal physiological process and no prevention is necessary. In some cases nuclear enlargement occurs in glands which are histologically closer to the normal proliferative pattern, in other words, in glands with minimal or no secretory activity. Arias stella reaction up to 10% of gravid hysterectomy specimens. Cove 37 and rhatigan 38 have described cases of endocervical ariasstella reaction that caused confusion with premalignant or malignant conditions. A panel of immunohistochemical markers comprising napsin a, hepatocyte nuclear factor1beta hnf1. I found a modified ariasstella reaction in paratubal epithelial cells.
The characteristic histologic features of the arias stella reaction include large cells with abundant eosinophilic or vacuolated cytoplasm, nuclear enlargement, and hyperchromasia 2. Extensive regions of necrosis better microscopic evidence must be sought before making a definitive diagnosis of carcinoma 59. Ariasstella reaction is usually seen in gestational endometrium or in ectopic gestation site and rarely in nonpregnant uterus with hormonal. Cytologically, it looks like a malignancy and, historically, it was diagnosed as endometrial cancer. The glands also show marked cytoplasmic vacuolization. The condition is a normal physiological process of the body, caused due to hormonal response. The arias stella phenomenon was first described by javier arias stella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue 1.
Decidualization of the endometrial stroma is the response of the uterine lining to products of the corpus luteum progestins. 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. Value of histopathologic examination of uterine products. A legal procedure for settling a dispute outside the courts, in which the parties select and agree to abide by the decision of a. When presenting in extrauterine sites, the differentiation of arias stella changes from other more ominous clear cell lesions may pose.
We decided to evaluate the subpopulations of treg cells and b7h4 macrophages in eutopic. 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. Histopathologic examination confirmed products of conception in 537 96. Use of oral contraceptives usually focal, superficial glands. However, the arias stella reaction is exceedingly rare in the fallopian tube, and may be confused with herpetic infection or malignancy. Arias stella reaction with a hypersecretorypattern shows strati. Immunohistochemical staining for ki67 and p53 helps. This code is grouped under diagnosis codes for diseases of the genitourinary system. Immunohistochemically, the tumor cells were positive for either er or pr, negative for p53. Stromal decidualization is not diagnostic of intrauterine. The char acteristic histologic features of the arias stella reaction include large cells with abundant eosinophilic or vacuolat ed cytoplasm, nuclear enlargement, and.
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