Microscopic examination of the endometrial polypoid tumor mass revealed intimate admixture of epithelial and non-epithelial (stromal) elements with areas of predominantly stromal component.(Image 04). The stromal cells are poorly differentiated and mitotically very active. These cells were focally admixed with undifferentiated round cells with abundant eosinophilic cytoplasm.(Image 05). Stroma focally shows papillary fronds covered by epithelium.(Image 06).
Epithelial component shows irregular papillary pattern and irregular glandular spaces. These papilla and glandular spaces are lined by stratified anaplastic cells with pronounced nuclear pleomorphism.(Image 07 and Image 08). Deep myometrial, lower uterine segment and cervical invasion were evident with positive cervical surgical resection margin. The papillary and glandular component was also identified in the left ovary.
The large subserosal leiomyoma of the uterus and the adjacent myometrium also shows dilated vascular and lymphatic channels filled with neoplasitc epithelial cells and occasional psammoma bodies.(Image 09).