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Fig. 6. Serous EIC and endometrial glandular dysplasia. p53 stain of serous EIC (Panel B) and endometrial glandular dysplasia (Panel A) show a gradation of cytological atypia and abnormal p53 staining between these entities. Both are in situ lesions, which frequently coexist in women with invasive papillary serous carcinoma. Endometrial glandular dysplasia example is kindly supplied by Wenxin Zheng, Yale University, New Haven, CT.

change and surface distributed carcinoma is difficult to resolve on morphological architectural grounds alone (52). In these instances, extreme cytological atypia is a key element of the diagnosis.

There is much less information about the precursors of type II cancers when compared with the abundant data for type I endometrial cancers. One reason is that papillary serous cancers are much less frequent than their endometrioid counterparts, making it difficult to assemble large series for study. Additionally a rapid tempo of papillary serous carcinoma emergence from an apparently normal state presents a narrow temporal window for clinical detection of early disease. Serous Endometrial intraepithelial carcinoma (EIC) and endometrial glandular dysplasia (EGD) are the best candidates for preinvasive malignant and premalignant papillary serous disease, respectively.

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