Professional Documents
Culture Documents
surgical pathology
Embryology
• The endometrium and the myometrium are of
mesodermal origin and are formed secondary to
fusion of the mullerian (paramesonephric) ducts
between the 8th and 9th postovulatory weeks.
• Until the 20th week of gestation
– Endometrium consists of a single layer of columnar
epithelium
– Supported by a thick layer of fibroblastic stroma.
• After the 20th week
– Surface epithelium invaginates into the underlying stroma
– Glandular structures formed that extend toward the
underlying myometrium.
• At birth
– Endometrium measures less than 0.5mm in thickness
– The surface and glands are lined by a low columnar to
cuboidal epithelium
– Epithelium is inactive.
• During the prepubertal years, the endometrium
remains inactive(similar to postmenopausal age).
Layers of endometrium
• In the reproductive years, there are two regions
– Superficial functionalis (stratum spongiosum)
– Basalis (stratum basale).
• The functionalis has greatest degree of hormonal
responsiveness, while basalis is less responsive, the
morphology not varying greatly during the menstrual cycle
• A biopsy consisting entirely of basalis is not adequate for
dating of the menstrual cycle.
• Usually, the endometrial glands are regularly spaced and have
a perpendicular arrangement from the basalis to the surface.
• The basalis abuts the myometrium and regenerates the
functionalis following its shedding during menstruation. The
basalis is composed of inactive appearing glands, cellular
stroma, and spiral arteries that have thicker muscular walls
than those in the functionalis.
• The endometrium during the
reproductive period undergoes cyclical
morphologic changes, which are
particularly evident in the superficial
two thirds, the so-called functionalis
layer.
• Morphologic alterations are minimal
in the deeper one third, the so-called
basalis layer. Functional layer develops
from it
• A=functionalis layer
• B=basal layer
• C=myometrium
Vascular anatomy
• The endometrial vascular supply
originates from the radial arteries of the
underlying myometrium.
• These arteries penetrate the
endometrium at regular intervals and
give rise to the basal arteries, which in
turn divide into
– Horizontal providing the blood supply to
the endometrial basalis
– Vertical branches supplying the overlying
functionalis layer.
• The endometrial vessels in the
functionalis layer are referred to as
spiral arteries.
• A differentiating feature between the
endometrial and myometrial arteries is the
absence of subendothelial elastic tissue in the
endometrial arteries, except for those in the
basal layer.
• Uterine lymphatics drain from subserosal
uterine plexuses to the pelvic and para-aortic
lymph nodes.
Epithelium of endometrium