Endometrial hyperplasia

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Endometrial hyperplasia
Classification and external resources
Simple endometrial hyperplasia - low mag.jpg
Micrograph showing simple endometrial hyperplasia, where the gland-to-stroma ratio is preserved but the glands have an irregular shape and/or are dilated. Endometrial biopsy. H&E stain.
ICD-10N85.0
ICD-9621.3
DiseasesDB4263
eMedicinemed/3334
MeSHD004714
 
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Endometrial hyperplasia
Classification and external resources
Simple endometrial hyperplasia - low mag.jpg
Micrograph showing simple endometrial hyperplasia, where the gland-to-stroma ratio is preserved but the glands have an irregular shape and/or are dilated. Endometrial biopsy. H&E stain.
ICD-10N85.0
ICD-9621.3
DiseasesDB4263
eMedicinemed/3334
MeSHD004714

Endometrial hyperplasia is a condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus.

Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including obesity, polycystic ovary syndrome, estrogen producing tumours (e.g. granulosa cell tumour) and certain formulations of estrogen replacement therapy. Endometrial hyperplasia is a significant risk factor for the development or even co-existence of endometrial cancer, so careful monitoring and treatment of women with this disorder is essential.

Classification[edit]

Like other hyperplastic disorders, endometrial hyperplasia initially represents a physiological response of endometrial tissue to the growth-promoting actions of estrogen. However, the gland-forming cells of a hyperplastic endometrium may also undergo changes over time which predispose them to cancerous transformation. Several histopathology subtypes of endometrial hyperplasia are recognisable to the pathologist, with different therapeutic and prognostic implications.[1]

Diagnosis[edit]

Diagnosis of endometrial hyperplasia can be made by endometrial biopsy which is done in the office setting or through curettage of the uterine cavity to obtain endometrial tissue for histopathologic analysis. A workup for endometrial disease may be prompted by abnormal uterine bleeding, or the presence of atypical glandular cells on a pap smear.[3]

Treatment[edit]

Treatment of endometrial hyperplasia is individualized, and may include hormonal therapy, such as cyclic or continuous progestin therapy, or hysterectomy.[3]

References[edit]

  1. ^ Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) (2002). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1. 
  2. ^ a b Kurman RJ, Kaminski PF, Norris HJ (1985). "The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients". Cancer 56 (2): 403–12. doi:10.1002/1097-0142(19850715)56:2<403::AID-CNCR2820560233>3.0.CO;2-X. PMID 4005805. 
  3. ^ a b Howard A Zacur, Robert L Giuntoli, II, Marcus Jurema. Endometrial Hyperplasia. UpToDate Online (subscription required). Retrieved 2007-05-26. 

See also[edit]