PTEN Progression Sequence 

Thumbnails
Progression Sequence
10 Normal
10 Anovulatory
10 EIN

Case Reports
by Diagnosis
by Minitable (horiz)
by Vol % Stroma
by Vol % Null Glands 
by Minitable(vert)
by Case Number
Report Format

Methods
Immunohistochemistry
Antibody 6H2.1
Result Key

PTEN immunohistochemical images of normal (proliferative), unopposed estrogen exposed (persistent proliferative), and frankly premalignant (EIN) endometria.  Presence of PTEN protein is indicated by a brown color, with circular PTEN-null glands appearing pale with a light green counterstain.

"Normal" Proliferative Endometrium: PTEN null glands are a small fraction of all endometrial glands, appearing as isolated tubular glands to small clusters of otherwise undistinguished glands.  Cytology, gland density, and gland size, are all identical to PTEN expresssing glands. 
   

Persistent Proliferative Endometrium (anovulatory, unopposed estrogens): PTEN null glands undergo architectural changes exactly in parallel with those seen in PTEN expressing glands exposed to estrogens for a protracted interval.  This includes a slightly increased gland density and increased average gland size, without any PTEN-specific alterations in cytology. 
 

EIN, Endometrial Intraepithelial Neoplasia: PTEN null glands are comprised of cells with a cytology clearly distinctive from background PTEN expressing glands ("cytologic demarcation).  The architecture also diverges between PTEN-null and expressing glands: sharp increases in density of PTEN-null glands is responsible for the rapid deline in Volume Percentage Stroma that characterizes EIN lesions.