En 1949, siendo estudiante de medicina y asistente libre en la cátedra de patología del Hospital Loayza, el Dr. Javier Arias Stella tuvo la oportunidad de estudiar dos pacientes que ingresaron por metrorragias y que mostraron en los estudios del tejido endometrial alteraciones atípicas que fueron interpretadas por sus profesores como atipias consistentes con neoplasias glandulares. No convencido de los diagnósticos pensó que se trataba de algún efecto de estímulo hormonal, por estar los dos casos relacionados a la gestación.
Más adelante, estando ya como Fellow en el Memorial Hospital for Cancer de New York, tuvo la oprtunidad de ampliar su investigación logrando la publicación original en 1954, de lo que hoy se denomina el Fenómeno Arias Stella. La principal característica de la alteración es el agrandamiento nuclear en las glándulas endometriales debido al incremento en el contenido del ADN. Las alteraciones son usualmente focales, comprometen grupos glandulares o sólo parte de ellos.
Artículos
Artículo original: Atypical Endometrial Changes Associated with the Presence of Chorionic Tissue
The purpose of this paper is to describe certain endometrial changes which occur in the presence of chorionic tissue and which, it is thought, result from the hormonal activity of this tissue. Although these alterations are not infrequent, we have been unable to find any study of their characteristics or any mention of them in a survey of current textbooks of pathology. Only a few references have been found that we think deal in part with the problem to be discussed. Deelman (6), in his "Die Histopathologie der Uterusmucosa", called attention to some endometrial patterns which occur in cases of uterine abortion and which can be confused with neoplastic growths.
Revisión reciente: The Arias-Stella Reaction: Facts and Fancies Four Decades After
Since its first description more than four decades ago, the atypical endometrial change associated with chorionic tissue effect has been widely confirmed in the literature. However, errors and inaccuracies in text books and other publications often occur. This review clarifies some of these misconceptions and presents a summary of new data on the histologic and immunohistochemical characteristics of the change. A brief discussion of the pathogenesis and biologic significance of the alteration is included.
