A hysterectomy specimen shows endometrioid adenocarcinoma in which 35 percent of the tumour is arranged in solid sheets, and well-formed squamous morules are present within the glandular areas. What is the FIGO grade?

• A Grade 1
• B Grade cannot be assigned until squamous areas are excluded entirely
• C Grade 3
• D Grade 2 ✓

Explanation

FIGO grading counts the percentage of solid nonsquamous growth: under 5 percent is grade 1, 5 to 50 percent is grade 2, and more than 50 percent is grade 3. Squamous differentiation and morules are deliberately excluded from the solid component when counting. With 35 percent true solid nonsquamous growth this tumour is grade 2. Excluding squamous areas first leaves 35 percent solid, so grade 2 remains correct regardless.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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