PRM-Associated Endometrial Changes (PAEC)
Epidemiology and Etiology:
- PRMs interact with the PR to inhibit or
stimulate a downstream hormonal response
- Compounds with progesterone receptor antagonist
activity are used in contraception and in the management of uterine
leiomyomata or endometriosis
- Selective Progesterone Receptor Modulators
(SPMRs)
Common sites:
Gross features:
- Fibristal:
- Endometrial thickening > 16 mm (11% of
subjects)
Histologic features:
- Inactive endometrium (some cases)
- Normal cyclical endometrium (some cases)
- PRM-associated endometrial changes (PAEC) (subset
of cases) (60% of patients on fibristal for 3
months)
- Asymmetry of stromal and epithelial growth
- Cystically dilated glands prominent
- Admixed hormonal effects in endometrial glands:
- Estrogenic (mitotic) and progesterone
(secretory) activity admixed
- Mitotically active glands combined with
secretory change
- Extensive apoptotic activity in areas
- Inactive glands in areas
- Vascular changes
- Chicken-wire vasculature
- Thick-walled and ectatic
vessels widely disseminated throughout the endometrium rather than in a
localized fashion as in a polyp
- Ectatic stromal blood vessels occasionally
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
References:
- Blaustein. (2011)
- Fibristal
product monograph, Actavis Specialty Pharmaceuticals Co. (2013)