Malignant tumor composed predominantly of solid sheets of highly pleomorphic cells, with prominent focal papillary structures and clear cell features. The tumor cells exhibit marked nuclear atypia, including hyperchromasia, irregular nuclear contours, and frequent macronucleoli. Focally, the cells show abundant, optically clear cytoplasm with distinct borders. Atypical mitotic figures and foci of necrosis are identified. Differential Diagnosis requires the use of p16, p53, Napsin A, and ER/PR to distinguish from serous carcinoma, clear cell carcinoma, or poorly differentiated endometrioid adenocarcinoma.
Postmenopausal bleeding with endometrial hyperplasia.
Soft tissue fragments collectively measured 2.5x2x0.8 cm, totally embedded.
D & C biopsy: