Asynchronous glands in secretory pattern endometrium: clinical associations and immunohistological changes

Aims The significance and pathogenesis of irregular or asynchronous maturation within endometrial glands remains uncertain. The aim of this study was to investigate differences in epithelial hormone receptor immunoreactivity and stromal cell calretinin, CD 34 and p16 expression in morphologically normal secretory endometrium and in asynchronous (non‐secretory) endometrial glands ( AEG s). Methods and results Nineteen consecutive endometrial specimens showing AEG s were examined. The mean age of the patients was 42.8 years, and the most common presenting symptom was menorrhagia. Immunohistological expression of oestrogen receptor ( ER ) α, of ER β and of progesterone receptor ( PR ) were compared in normal secretory glands and in AEG s. Stromal cell expression of calretinin, CD 34 and p16 was also investigated. In contrast to normal secretory glands, the epithelial cells lining AEG s were usually ER α/ PR ‐positive and showed significantly increased ER β expression. Altered calretinin and CD 34 expression within functional layer stromal cells was seen in five and two cases, respectively, but there were no differences in stromal cell immunoreactivity around AEG s. Conclusions The most common clinical symptom associated with AEG s in this study was menorrhagia. Aberrant hormone receptor expression in AEG s suggests a localized, possibly clonal, defect in epithelial maturation. There were no immunophenotypic changes to suggest that AEG s are related to a primary endometrial stromal deficiency.