stroma. Endometrial polyps are benign in nature and affect both reproductive age and postmenopausal women. cally, the endometrium may show a spectrum of change ranging from total atrophy (basalis layer only) to a weakly proliferative endometrium with occasional mitotic figures and a thin functionalis layer. 5. Proliferative activity is relatively common in postmenopausal women ~25%. Deborah. endometrium, biopsy: - consistent with menstrual phase endometrium: -- weakly proliferative endometrial glands with neutrophils and apoptosis. Abstract. What do the results of my endometrial biopsy mean? Here are some words and phrases you might see on your biopsy results: Proliferative endometrium; Atrophic endometrium ; Hyperplasia; Carcinoma; If you see either of the first two phrases, your results are normal. The 2024 edition of ICD-10-CM N85. EH, especially EH with atypia, is of clinical significance because it may progress to. PIP: Steroid sex hormones cause immediate changes in the endometrium. received endo biopsy result of secretory, focally inactive endometrium, neg for hyperplasia and malignancy. 6 percent) Fibroid (6. Microscopic (histologic) description. 9% of them developed endometrial cancer or hyperplasia, a four-fold greater. Endometrial metaplasia can be associated with hyperestrogenism, inflammation, repeated irritation or endometrial polyps. Endometrium at menopause is inactive and free of cyclical changes that are characteristics of the reproductive age. Proliferative endometrium is part of the female reproductive process. During menopause, the ovaries produce fewer hormones, leading to a cessation of the menstrual cycle. 10. Some, but not all features of atrophy may also be seen in. Weakly proliferative endometrium means that the Prempro is causing some buildup of your uterine lining, which has led to the bleeding. 8 may differ. Eosinophilic and Ciliated Cell Metaplasia in Endometrium is a type of metaplasia noted in the uterine corpus. 6% in postmenopausal patients, 91% in premenopausal patients, and 81% for EIN. Proliferative/secretory (14. doi: 10. 1, 2 They are the second most common uterine mesenchymal tumor after leiomyosarcoma. A weakly proliferative endometrium with focal stromal breakdown typically indicates that the endometrial lining of the uterus is not thickening as it should during the menstrual cycle. 09–7. Endometrium biopsy: blood and weakly proliferative phase endometrium with glandular and stromal breakdown. Deborah Josefson: Excess estrogen : This is suggestive of an increased estrogen state an. 1,758 satisfied customers. Too thin or too thick endometrium. 4 It is a disease of ageing, with over 80% of cases occurring during the. Of the 142 specimens, 59 (41. DDx. The endometrium, a tissue of continuously changing patterns and immense proliferative activity during a woman’s reproductive life, becomes atrophic after the menopause as a result of ovarian failure. Thank. What does disordered proliferative endometrium mean? Disordered proliferative endometrium is a non-cancerous change that develops in the endometrium, a thin layer of tissue that lines the inside of the uterus. 8 is applicable to female patients. Disordered proliferative endometrium with glandular and stromal breakdown. Furthermore, 962 women met the inclusion criteria. Dating of endometrium: Proliferative phase. • 01-2021 Vaginal Ultrasound: Showed 3 fibroids, endometrium lining 8. In the present pictorial review, we briefly discuss the various morphologic. It can affect nearby organs, including the bowel and bladder. N85. Acute endometritis can happen after childbirth or miscarriage, or after a surgical procedure involving your cervix or uterus. Relatively normal gland to stroma ratio (glands occupy < 50% of the. Decidualization may be seen in a. 1646 postmenopausal women aged 55-96 (mean 64. The polyp is made up of an increased number of otherwise normal-appearing endometrial glands and stroma. 5 cm. The functional layer thickens and then is shed during menstruation in humans and some other mammals, including apes, Old World. 1 Patients often. It is diagnosed by a pathologist on examination of endometrial tissue under a microscope. It refers to the time during your menstrual cycle when a layer of endometrial cells is prepared for attachment of a fertilized egg. While secretory changes in endometrial glands can be observed occasionally at birth, decidual or menstrual changes are rare ( 25 ). This pattern is sometimes seen in women with dysfunctional bleeding Progestational Agents Marked pseudo-decidualization of stroma. Plasma cells were rare in inactive endometrium and noted in only 18% of unremarkable proliferative endometrium, all grade 1. 3–10% of endometrial biopsies are said to show histologic evidence of chronic endometritis. Endometrioid. Proliferative endometrium is the time when your uterine lining is prepared for a fertilized egg to attach. Fewer than 2% of cases of endometrial hyperplasia without cytological atypia progress to endometrial carcinoma, compared with 23% of cases of endometrial hyperplasia with cytological atypia that progress to carcinoma (atypical hyperplasia; Kurman et al. Proliferative endometrium isn’t a symptom or condition. It is a special type of tissue that helps hold the other parts of the organ together. Endometrium with changes due to exogenous hormones is relatively common in endometrial samples. Hysteroscopy can identify malignant or benign pathology with approximately 20% false-positive results. The two biopsies showed a normal proliferative pattern endometrium. the expression of Bcl-2 in the proliferative phase polyps in both the glandular epithelium and stroma compared with. Family Medicine 49 years experience. They described functional endometrium as being “weakly proliferative” or “weakly. In one study, follow-up outcomes of "gland-crowding" reports show 77% benign lesions (proliferative endometrium, secretory endometrium, endometrial polyp, etc. Re: What is weakly proliferative endometrium. Represents the most common form and is characterized by glandular proliferation, with variable shape and size, bordered by proliferative epithelium with mitotic activity; the interglandular stroma can be reduced, the differentiation from endometrial hyperplasia being made on account of the vessels with. Hence, it is also known as Metaplastic Changes in Endometrial Glands. Endometrial morphology after 6 months of continuous treatment with a new gonadotropin-releasing hormone superagonist for contraception. Early diagnosis and treatment of EH (with or without atypia) can prevent progression to. 3. read moreSpecimens A. Hematoxylin and eosin staining of the tissue revealed weakly proliferative endometrium with multiple compact, nonnecrotizing granulomas . 3% had actively proliferative endometrial histology, and 0. . Cystically dilated glands (> 2x normal size) randomly interspersed among proliferative endometrial glands. They consist of proliferative endometrium (sometimes weakly proliferative), often with stromal breakdown, and/or of endometrial hyperplasia. Endometrial hyperplasia without atypia (as in the 2020 WHO classification) is defined as the proliferation of endometrial glands of irregular size and shape without significant cytological atypia. tubal/eosinophil hyperpla A Verified Doctor answered Dr. Conditions that involve the endometrium and may impact fertility include: Adenomyosis. Introduction. Ed Friedlander and 4 doctors agree. Menstrual endometrium is characterized by an influx of inflammatory cells, thrombi in stromal vessels, apoptosis and gland-stromal dissociation. The proliferative endometrium is what is shed from the uterus when a woman has her cycle. "FRAGMENTS OF WEAKLY PROLIFERATIVE ENDOMETRIUMWITH GLANDULAR AND STROMALBREAKDOWN"? Can somebody explain this to me in English please? Answer. 5 ±17. Created for people with ongoing healthcare needs but benefits everyone. Prolonged exposure to progesterone induces a rounded cell characterized. At the start of the menstrual cycle, the ovaries secrete the estrogen hormone, triggering the endometrium to enter a proliferative phase, during. What does atrophic endometrium mean? Atrophic endometrium is a non-cancerous change that occurs in the tissue lining the inside of the uterus. Personal hx colorectal cancer Endometrial polyp Morbid obesity Presence of one or more factors, increases risk by 8 times. MD. An endometrial polyp was found in 86. This definition comprises various types of hormonally induced metaplastic changes in the endometrium observed both in benign and premalignant or malignant conditions [9,10,11]. Early proliferative (day 4-7 ) Straight short glands, thin epithelium. The proliferative and hyperplastic endometrium was commonly reported. Europe PMC is an archive of life sciences journal literature. Cardiovascular surgeon. Best would be to contact the pathologist who wrote the report. (female) Join Date: Nov 2007. 8% of all surgical specimens of women with PE. Signs and symptoms of uterine polyps include: Vaginal bleeding after menopause. Oral contraceptives (OCs) containing a low-dose, low-potency progesterone and low-dose estrogen stop proliferation of the glands during the 1st few cycles and the glands are. Contrary to endometrial hyperplasia,. No hyperplasia or malignancy was observed. Introduction. In your case, there could be no enough progesterone to organize the proliferation caused by the estrogen and when the phase of secretion. 2 mm thick (mean, 2. Definition / general. Women with a proliferative endometrium were younger (61. Disclaimer: Information in questions answers, and. Fibroids (benign uterine muscle growths) and polyps (endometrial masses) often cause no symptoms. the mean age, weight, FSH and oestradiol. No malignancy was recognized. ( I have had 5 endometrium biopsies over past 4 years and one D&C 6 years ago) • 01-2021 Endo Biopsy Diagnosis: Pre-hyperplasia, Disordered proliferative endometrium without atypia. What does fragment of Proliferative Endometrium mean on the biopsy report? 2 doctor answers • 4 doctors weighed in. resembling proliferative phase endometrium. Similar to the cells normally found in the fallopian tube, the cells often have small hair-like projections called cilia. The immunohistochemical staining pattern for CD138 with appr. New blood vessels develop and the endometrial glands become bigger in size. However, there is little literature and no evidence-based treatments for a finding of proliferative endometrium without atypia on Pipelle endometrial biopsy in women. This pictorial review takes you through the hysteroscopic view of normal-looking. Some fragments may represent. Adenofibroma. These layers become more pronounced. Created for people with ongoing healthcare needs but. isnt the first part contradictory of each other or is everything normal?" Answered by Dr. 0000000000005054. 6 kg/m 2; P<. The prevalence of endometriosis in reproductive-aged women is 2% to 10%, while in those who have been through menopause, the prevalence is an estimated 2. Biopsy proliferative phase endometrium with disorder features and focal stromal breakdown. Applicable To. This is the American ICD-10-CM version of N85. The term describes healthy reproductive cell activity. 2. Van den Bosch et al 11 found that 14. read more. 1. While secretory changes in endometrial glands can be observed occasionally at birth, decidual or menstrual changes are rare ( 25 ). Proliferative Endometrium in Menopause: To Treat or Not to Treat? Obstet Gynecol. or weakly proliferative (P=0. No polarizing material was present in the granulomas, and. Endometrial metaplasias and changes (EMCs) are conditions frequently overlooked and misdiagnosed. Because these cells appear unusual or "atypical" and because they may line. A menstrual cycle for one woman may last for a few days but for another woman may last a. Learn how we can help. Conclusion One in six postmenopausal women who underwent endometrial sampling had proliferative endometrium. Fibroids (benign uterine muscle growths) and polyps (endometrial masses) often cause no symptoms. Smith et al 16 reported that 348 of 1832 women (19%) with PMB had “functional endometria” in their initial evaluation of PMB. General Surgeon. Women with a proliferative endometrium were younger (61. This article discusses briefly. Blood. Localized within the uterine wall, extends into the uterine cavity. Early proliferative (day 4-7 ) Straight short glands, thin epithelium. The endometrium from the uterine body and fundus is generally fairly uniform from one area to another. Endometrial carcinomas account for the greatest number of these cases, as fewer than 10% of uterine corpus cancers are sarcomas. Frequently, in histological samples of EGBD, metaplastic changes occur also in the endometrial surface epithelium (Figs. ( I have had 5 endometrium biopsies over past 4 years and one D&C 6 years ago) • 01-2021 Endo Biopsy Diagnosis: Pre-hyperplasia, Disordered proliferative endometrium without atypia. 5), with loss of distinction between the basal and functional layer; (b) proliferative type endometrial glands, somewhat tortuous, with tall columnar pseudostratified epithelium, oval. What does this test result mean. Wechat. Hysteroscopy is the gold standard to evaluate the endometrial cavity. 2023 Feb 1;141 (2):265-267. If left untreated, disordered proliferative endometrium can change into another non-cancerous condition called. The follicular phase of the female menstrual cycle includes the maturation of ovarian follicles to prepare one of them for release during ovulation. The specimen is received. Open in a separate window. endometrium, biopsy: - consistent with menstrual endometrium: -- stripped weakly proliferative endometrial glands. Dr. My interpretation is that the pathologist saw fragments of endometrium in the proliferative phase, in contrast to the secretory phase. what does that mean? 1 doctor answer • 1 doctor weighed inWhat do these endometrial biopsy results mean:diagnosis: endometrium, biopsy - scant strips of inactive glandular epithelium admixed with inflamed mucus, keratin debris and blood. While embryo development and endometrial preparation are concurrent yet independent processes, their synchronization is critical to the success of embryo apposition, adhesion, invasion, and further ongoing. 186 satisfied customers. 0001). 0–3. Dating of endometrium: Proliferative phase. Weakly proliferative endometrium is a normal finding in some women, but it can also be a sign of cancer or other problems. No apparent endometrial hyperplasia was seen. The uterus is lined with a special tissue called the endometrium. -- abundant neutrophils and blood. The endometrium is obtained for evaluation by a process called dilatation and curettage or by endometrial biopsy. •ICCR definition:-REQUIRED ELEMENTS- those which are unanimously agreed by the panel to be essential for the histological diagnosis, clinical. 7. The metaplasia doesn't mean anything significant, and the glandular and stromal breakdown is often seen when there has been bleeding. Barbara MacFarlane: : A secretory endometrium is at the end of the cycle and is. 8% of all surgical specimens of women with PE. 3% had proliferative pattern (disorder type) tissue; 0. Normal : It's benign tissue that shows estrogen effect (proliferative endometrium), cell changes that are benign (ciliated metaplasia) & no precancerous or can. The degree of proliferation can vary in proportion to the estrogenic stimulus. (b) On CD10 immunohistochemistry, the stroma stains positive, confirming endometrial-type stroma, while the endometrial glands are negative. A "d&c" which is reported as "scant glandular endometrium " is a benign pathological condition. Normal : It's benign tissue that shows estrogen effect (proliferative endometrium), cell changes that are benign (ciliated metaplasia) & no precancerous or can. 2 percent) By comparison, the background prevalence of endometrial pathology in postmenopausal patients without bleeding is lower. 04, 95% CI 2. DDx. Dr R. The functional layer thickens and then is shed during menstruation in humans and some other mammals, including apes, Old World. 00 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 10 ) [ 1 , 10 , 11 ]. 5 ±17. Your provider can also use endometrial. Read More. Introduction. In the past, the terms “adenomatous hyperplasia” and “atypical hyperplasia” were used to denote proliferative lesions of the endometrium with varying degrees of architectural complexity and cytologic atypia [15, 32, 37, 70, 93]. These sound like the results from an endometrial biopsy - basically, when your doctor takes a clipping or scraping from inside the uterus and sends it off to a pathologist to be examined. Endometrial changes of oral contraception, oral contraceptive effect, OCP endometrium, and endometrium with hormonal changes redirect here. Endometritis is inflammation of the endometrium (the inner lining of your uterus) due to infection. For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts. Glands. In the past, the terms “adenomatous hyperplasia” and “atypical hyperplasia” were used to denote proliferative lesions of the endometrium with varying degrees of architectural complexity and cytologic atypia [15, 32, 37, 70, 93]. Read More. A hysterectomy makes it impossible for you to become pregnant in the future. In this phase it is called Proliferative Endometrium. 04, 95% CI 2. 1 Characterized by ciliated columnar cells with bland round nuclei and eosinophilic cytoplasm, similar to the cells. The belief that stromal cell proliferations in the endometrium are by definition neoplastic was first challenged by Stewart et al. Screening for endocervical or endometrial cancer. Occasionally in the latter situation, when the proliferative phase is prolonged, there may be sufficient residual oestrogen secretion toWhat does weakly proliferative mean? Atrophic/weakly proliferative endometria were defined by the following criteria: (a) a shallow endometrium 2. Cytoplasmic vacuoles become supranuclear and secretions are seen within glandular lumina (Fig. 11. Obstetrics and Gynecology 41 years experience. Figure 1. The unstained glands are irregularly dispersed with focal back-to-back crowding. Blood. In a review of 518 nonirradiated hysterectomy specimens with endometrial carcinoma and 39 with carcinosarcoma, 86 cases were identified in which there were microscopic foci of malignant epithelium that failed to alter the architecture of an otherwise thin atrophic or weakly proliferative endometrium or endometrial polyp. Between the 19th and 23rd day of a typical 28-day cycle (the mid-secretory phase), the degree of glandular secretion increases. A result of disordered or crowded glands is common with anovulatory cycles due to. Is this a diagnosable condition? Proliferative endometrium isn't a symptom or condition. Weakly proliferative endometrium Normal proliferative endometrium Disordered proliferative Endometrial hyperplasia Asynchronously developed endometrium. The study provides. The study of endometrial carcinoma at menopause presents an interesting challenge. 2 mm thick (mean, 2. It can be healthy or disordered depending on the rate of cell growth and shedding. Weakly proliferative endometrium does not denote a specific functional state but is better conceptualized as a morphologic pattern. Learn how we can help. The last menstrual period should be correlated with EMB results. 0; range, 1. thank you endometrium, biopsy: -glandular and stromal breakdown, consistent with bleeding changes -negative for atypia or malignancy?. Infertility. 0001) and had a higher body mass index (33. . “The growth, or proliferative, phase of the endometrium happens in the first half of the menstrual cycle prior to ovulation when an ovary releases a mature egg,” explains Dr. 5. This was done in 3 parts: (1) retrospective chart review of all patients with reported insufficient or scant endometrial samples from 2010 to 2013 at our center to determine repeat sampling and final pathologic diagnosis; (2) survey of gynecologists about their practice for managing patients with these samples; (3) blind review of 99 cases of. Demosthenes, MD. -- abundant neutrophils and blood. What does disordered proliferative endometrium mean? Disordered proliferative endometrium is a non-cancerous change that develops in the endometrium, a thin layer of tissue that lines the inside of the uterus. 1 The American College of Obstetricians and Gynecologists (ACOG) recommends endometrial tissue sampling in any woman with abnormal uterine bleeding who is older than 45 years, or in. Proliferate definition: . Specimen was received in formalin and consists of mucoid. Endometrial hyperplasia is an abnormal proliferative response to estrogenic stimulation. 2 vs 64. In the endometrial carcinoma, the staining signal was. Proliferative is first part of cycle, dominated by estrogen. What does this mean?Endometrial biopsy:benign proliferative endometrium with ciliated cell metaplasia without hyperplasia or malignancy. Harold Fields answered. SEE COMMENT. N85. Eosinophilic cell change was more frequently seen in endometrial hyperplasia and carcinoma than in benign nonhyperplastic endometrium. Dilated glands usually with irregular shape (branched, convoluted, scalloped outer contours) > 10% of overall glands. The endometrium becomes thicker leading up to ovulation to provide a suitable environment for a fertilized egg to grow inside the uterus. A hysterectomy stops symptoms and eliminates cancer risk. The endometrial tissue is a sensitive target for steroid sex hormones and is able to modify its structural characteristics with promptness and versatility. Endometrial polyps. The findings in endometrial biopsies taken for abnormal uterine bleeding can show a wide range of appearances that reflect the cyclical changes in the endometrium in women during their reproductive years; accordingly, the histopathological diagnosis provides a description of the features observed microscopically (e. Hence, it is also known as Metaplastic Changes in Endometrial Glands. What do these results mean: ENDOMETRIAL BIOPSY: WEAKLY PROLIFERATIVE ENDOMETRIUM WITH FOCAL STROMAL AND/OR GLANDULAR BREAKDOWN. Surgery. Learn more about the causes, diagnosis, and treatment of this condition. 1 Definition and Clinical presentation . 0001). The Proliferative Phase. A Verified Doctor answered. It is also the early proliferative phase and hence, a mixture of changes associated with menses and the early proliferative endometrium is seen . . X. Wendy Askew answered. Compact. In CPE, there are no specific clinical features that correlate with the intensity of pathologic findings; the most specific histologic feature is the presence of plasma cells, and it is predominantly identified in weakly proliferative endometrium. Wendy Askew answered. this is a description of the uterine lining in response to estrogen. In endometrial carcinomas, eosinophilic cell change was frequently associated with mucinous metaplasia and the two types of metaplastic cells were occasionally intermingled in a single neoplastic gland. 02 - other international versions of ICD-10 N85. [1] This imbalance in the hormonal milieu can be seen in a number of conditions where the cause of estrogen. Created for people with ongoing healthcare needs but benefits everyone. IHC was done using syndecan-1. When cancer grows in this lining, it is called. Hormonal or irritative stimuli are the main inducing factors of EMCs, although some metaplasias have a mutational origin. If the biopsy was done in the first half of the cycle, the endometrium is expected to be in proliferative phase. 02 became effective on October 1, 2023. 0001) and had a higher body mass index (33. At least she chatted to you as much as possible about the results. EMCs. 81, p < 0. At this. What is it? Symptoms Complications Treatment Summary Disordered proliferative endometrium can cause spotting between periods. By definition, adenocarcinoma of the endometrium is an invasive disease, invading either the endometrial stroma or the underlying myometrium of extrauterine tissues. An “insufficient” EMB result should always be viewed cautiously, especially in the setting of persistent postmenopausal bleeding. Markedly atypical nuclei identical to those of invasive serous carcinomas, lining the surfaces and glands of an atrophic endometrium. Therefore, it is necessary to know the phase of the menstrual cycle and the endometrial biopsy volume to. To evaluate prevalence, clinical and sonographic characteristics and long-term outcome of Estrogenic/proliferative Endometrium (EE) in women with postmenopausal bleeding (PMB). Because atrophic postmenopausal endometrium is no longer active, there are few or no mitotic cells. The risk. Inactive endometrium is normal in post menopausal women. [10]: (1) constant appearance of basalis throughout the menstrual cycle, (2) glands of the basalis appear weakly proliferative, (3) basalis cells lack secretory features and the stroma is spindled. Two thirds of proliferative endometrium with breakdown showed plasma cells (19% grade 1, 39% grade 2, 10 % grade 3). This definition comprises various types of hormonally induced metaplastic changes in the endometrium observed both in benign and premalignant or malignant conditions [9,10,11]. The basic effect of estrogens on the endometrium is to induce proliferation of the endometrial glands and stroma, including vascular endothelium. I am postmenopausal with uterine bleeding. 14. Proliferative endometrium describes the 'stage' of the endometrium when it was biopsied. It may be associated with abnormal menstrual bleeding or infertility. Initial evaluation — The primary goal in the diagnostic evaluation of postmenopausal patients with uterine bleeding is to exclude. Read More. In the 2003 World Health Organization. General Surgeon. Dr. Endocervical/tissue: A "pap smear" may contain some tissue from the canal leading to the womb (endocervical canal) which grows out over the surface of the cervix and is se. 5 to 7–8 mm during the mid-proliferative phase ( 17 ). In one study, follow-up outcomes of "gland-crowding" reports show 77% benign lesions (proliferative endometrium, secretory endometrium, endometrial polyp, etc. This may explain the development of endometrial adenocarcinoma in. The polyp sticks out from the thin layer of tissue on the inside uterus called the endometrium. Characteristics. On pap tests this is associated with the classic double contoured balls of endometrial epithelium and stroma. 5 years; P<. The uterus is the hollow, pear-shaped pelvic organ where fetal development happens. Endometriosis can reactivate after menopause, particularly if estrogen levels rise again, such as after starting hormone replacement therapy. ICD-10-CM Coding Rules. Created for people with ongoing healthcare needs but benefits everyone. Obstetrics and Gynecology 32 years experience. Pediatrics 35 years experience. Introduction. -. Treatment also usually includes the removal of the fallopian tubes and ovaries, called a salpingo-oophorectomy. Adenofibromas most commonly occur in postmenopausal women but the age range is wide. Pseudoneoplastic glandular response of the female genital tract, first described by Javier Arias-Stella in 1954 as atypical endometrial changes associated with the presence of chorionic tissue ( AMA Arch Pathol 1954;58:112 ) Typically found in the endometria of postabortion curettings of intrauterine or extrauterine pregnancies or with. Physician. If the biopsy was done in the first half of the cycle, the endometrium is expected to be in proliferative phase. 5 per 100 000 women per year in the United States. Doctor of Medicine. 3,291 satisfied customers. 9 and 12. 2; median, 2. This study examines the morphological and immunohistochemical features of endometrial metaplastic/reactive changes that coexist with endometrial hyperplasia and carcinoma. A slightly disordered endometrium is a form of cancer. I am postmenopausal with uterine bleeding. Definition. An endometrial polyp was found in 86. - Negative for. Before treatment, 56 subjects (60%) had an endometrial biopsy with findings classified as weakly proliferative or proliferative. 2 weakly proliferative endometrium, 3 disordered prolifera-tive. As a result, the endometrium becomes thin and atrophic, displaying characteristics of inactivity. Ed Friedlander and 4 doctors agree. Read More. On pap tests this is associated with the classic double contoured balls of endometrial epithelium and stroma. Dr.