No adnexal masses were felt. A pregnancy test was negative. Vaginal cytology was normal. Uterine curettage showed a secretory endometrium. An abdominal hysterectomy was performed.
Mitotic activity is the main criterion.
Other features to consider include cellular atypia, abnormal mitotic figures, extent of necrosis, and presence of myometrial or vascular invasion. A 59 year old woman had a persisting white plaque of the vulvar skin which was biopsied and then resected. Describe the histologic changes which are present. Atypical cytologic changes including increased nuclear-cytoplasmic ratio, loss of polarity, increased mitotic activity and pleomorphism of the epithelial cells in the epidermis, in some foci extending almost throughout the full thickness of the epidermis. The basement membrane is intact and there is not fibroblastic response in the surrounding tissues.