Endometrial curettings from a 64-year-old woman show malignant epithelial cells with abundant clear cytoplasm arranged in tubulocystic and papillary patterns, with nuclei protruding into glandular lumina giving a hobnail appearance. Which diagnosis fits this description?

• A Uterine serous carcinoma
• B Clear cell carcinoma of the endometrium ✓
• C Grade 3 endometrioid adenocarcinoma
• D Carcinosarcoma

Explanation

Clear cell carcinoma of the endometrium is defined by cells with optically clear or eosinophilic cytoplasm arranged in tubulocystic, papillary or solid patterns, often with characteristic hobnail nuclei projecting into lumina. Uterine serous carcinoma shows marked nuclear pleomorphism with slit-like glands rather than clear cytoplasm. Grade 3 endometrioid tumours retain solid endometrioid architecture, and carcinosarcoma contains a distinct malignant mesenchymal component.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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