This composite figure illustrates the multi-modal diagnostic findings of dedifferentiated endometrioid carcinoma of the uterus. Panel 1A presents a pelvic ultrasonogram demonstrating a thickened, homogenous myometrium with a poorly defined endo-myometrial junction (indicated by a black arrow). Panel 1B shows a gross pathological specimen of a bivalved uterus; the cut surface reveals an irregular, grey-white endometrial tumor mass (black arrows) with deep myometrial invasion. Panels 1C, 1D, and 1E are H&E-stained photomicrographs detailing the tumor's biphasic histology. Panel 1C (black arrows) shows the undifferentiated component, characterized by solid sheets of monomorphic tumor cells lacking architectural differentiation. Panel 1D (blue arrows) depicts the well-differentiated component, featuring organized glandular structures characteristic of low-grade endometrioid adenocarcinoma. Panel 1E captures the hallmark features of this entity: an abrupt transition and juxtaposition between the well-differentiated glandular areas (blue arrows) and the solid, undifferentiated sheets (black arrows). This combination of imaging and histopathology is critical for differentiating this aggressive carcinoma from standard FIGO Grade 2 or 3 endometrial cancers.

This dual-panel image displays the macroscopic and microscopic features of Grade 3 endometrioid adenocarcinoma of the uterus. Panel (a) is a clinical photograph of a gross surgical specimen (total abdominal hysterectomy) featuring a voluminous, exophytic tumor mass within the uterine corpus. The tumor exhibits a variegated light-tan to pale-red appearance with a nodular, lobulated surface and areas of apparent hemorrhage. A metric ruler indicates the primary mass is approximately 7 cm in maximum dimension. Panel (b) shows a light microscopy image (H&E stain) of the tumor at low magnification (1.0 mm scale bar). The histology demonstrates high-grade (G3) features, characterized by a complex, disordered growth pattern and back-to-back irregular glandular structures with significant loss of intervening stroma. The cellular architecture reveals significant atypia, solid growth components, and architectural complexity consistent with a high-grade endometrial malignancy. The images together illustrate the correlation between a large, invasive gross tumor and its poorly differentiated histological characteristics in the context of stage 3A endometrial carcinoma.

Imaging modality: Histology (Light microscopy) of uterine tissue section stained with Hematoxylin and Eosin. Specimen: uterine lesion in a paraffin-embedded tissue block; section thickness 4–5 μm; magnification range from 4x to 40x to evaluate architecture and cytology. Location: uterus, involving endometrium with adjacent fibromatous stroma; papillary fronds project into glandular spaces; stalks are sessile or papillary; epithelium is endometrioid, endocervical, or tubal type and shows no cytologic atypia. Tumor architecture is predominantly benign with fibromatous stroma supporting papillary fronds, consistent with adenofibroma. Rarely, ducts or glands may harbor foci of adenocarcinoma; presence of malignancy should be carefully assessed for invasion versus incidental focal carcinoma. Myometrial invasion is not a prominent feature in classic adenofibroma. Immunohistochemistry is not routinely required but can aid in differential diagnosis (estrogen/progesterone receptor positivity in glandular epithelium; stromal markers). Clinical relevance: benign neoplasm most often seen in postmenopausal women presenting with abnormal uterine bleeding; critical to distinguish from endometrial adenocarcinoma and atypical polypoid adenomyoma. Ethical considerations: ensure accurate reporting to prevent overtreatment. Use: educational reference for gynecologic pathology; supports differential diagnosis and surgical decision-making. This description emphasizes tissue architecture, epithelial lineage, and stromal context essential for accurate grading, prognosis, and patient management decisions overall.

Educational medical illustration and histology panel depicting the major subtypes of epithelial ovarian carcinoma and their anatomical context. The upper section features a coronal cross-section of the female reproductive tract, including labels for the uterus, fallopian tube, fimbria, ovary, endometrium, cervix, and vagina. A shaded circle on the right ovary highlights the hypothesized site of origin for these carcinomas, showing maturing follicles and a developing tumor. The lower section consists of four Hematoxylin and Eosin (H&E) stained micrographs representing the primary histologic subtypes: 1. Serous: exhibiting complex papillary architecture and high-grade nuclear features reminiscent of fallopian tube epithelium. 2. Endometrioid: showing glandular structures resembling endometrial glands. 3. Mucinous: displaying organized glands lined by mucin-producing columnar cells similar to endocervical epithelium. 4. Clear cell: demonstrating characteristic cells with abundant clear cytoplasm. This composite image serves to correlate anatomical origin with the divergent histological manifestations of ovarian cancer.