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Endometrial stromal tumours revisited: an update based on the 2014 WHO classification
  1. Rola H Ali1,
  2. Marjan Rouzbahman2
  1. 1Department of Clinical Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait, Kuwait
  2. 2Department of Anatomical Pathology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr Rola H Ali, Department of Clinical Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, PO Box 24923 Safat, Kuwait 13110, Kuwait; rolapathology{at}


Endometrial stromal tumours (EST) are rare tumours of endometrial stromal origin that account for less than 2% of all uterine tumours. Recent cytogenetic and molecular advances in this area have improved our understanding of ESTs and helped refine their classification into more meaningful categories. Accordingly, the newly released 2014 WHO classification system recognises four categories: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS) and undifferentiated uterine sarcoma (UUS). At the molecular level, these tumours may demonstrate a relatively simple karyotype with a defining chromosomal rearrangement (as in the majority of ESNs, LGESSs and YWHAE-rearranged HGESS) or demonstrate complex cytogenetic aberrations lacking specific rearrangements (as in UUSs). Herein we provide an update on this topic aimed at the practicing pathologist.


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