Figure - available via license: Creative Commons Attribution 2.0 Generic
Content may be subject to copyright.
Cystically dilated endometrial glands lined by a single layer of columnar epithelium (Hematoxylin and eosin stain, ×20)

Cystically dilated endometrial glands lined by a single layer of columnar epithelium (Hematoxylin and eosin stain, ×20)

Source publication
Article
Full-text available
THE BIOLOGICAL BEHAVIOR OF ENDOMETRIAL CARCINOMA DIFFERS IN EPIDEMIOLOGY, PRESENTATION, AND PROGNOSIS, SUGGESTING THAT THERE ARE TWO FUNDAMENTALLY DIFFERENT PATHOGENIC TYPES OF DISEASE: type I (estrogen related, endometrioid type) and type II (non-estrogen related, non-endometrioid type). Untreated hyperplasia can develop into an endometrioid type...

Similar publications

Article
Full-text available
Natural history and clinicopathologic features of early endometrial carcinoma are not evident. Its knowledge is essential to make up strategies for prevention, early detection, and treatment of endometrial carcinoma. Especially it is important to know pathways of endometrial carcinogenesis and frequency of endometrial carcinomas arising from endome...
Article
Full-text available
Objective: The aim of this study was to evaluate the accuracy of 3D transvaginal sonography and power Doppler in the differentiation between endometrial hyperplasia and endometrial carcinoma. Patients and methods: Forty-two women suffering from abnormal uterine bleeding (AUB) were examined by 3D TV sonography and power Doppler angiography and all t...
Article
Full-text available
Objective: The differentiation of atypical complex type endometrial hyperplasia (ACEH) and low grade endometrial carcinoma (EC) may be problematic in endometrial biopsy materials. Desmoplasia and stromal invasion are diagnostic for EC but they are not always demonstrated in endometrial biopsies. In this study, we investigated the contribution of nu...

Citations

... The risk of EH without atypia progressing to endometrial cancer is 1%~3%, and the risk of EH with atypia progressing to endometrial cancer is 25%~40% [2]. It is a common endometrial lesion causing abnormal uterus bleeding (AUB) [3], and we found that EH (including endometrial hyperplasia without atypia; mild, moderate and severe atypia) accounted for 45% of AUB cases [4]. Polycystic ovary syndrome (PCOS) is characterized by the ultrasonographic appearance of polycystic ovaries, ovulatory dysfunction, and hyperandrogenism, resulting in approximately 8.3%~9.13% of adolescent and reproductive-aged women to infertility [5]. ...
... Metabolic dysfunction characterized by insulin resistance was evident in the vast majority of affected individuals [2]. There was increasing studies indicated that the application of insulin sensitizers, such as metformin (MET), can improve the reproductive function of PCOS patients [2,3]. And SIRT1 agonist such as exenatide (EX) appeared to be superior to MET in restoring menstrual cycles and regulating metabolic disorders [6]. ...
Preprint
Full-text available
Exenatide can contribute to the therapeutic effect for PCOS patients in restoring menstrual cycles. To exploring endometrial tissue change in PCOS rats and the effects of exenatide on endometrial tissue, we carried out in vivo study of PCOS rat models. Method: PCOS rat models were obtained after DHEA treatment, and the corresponding parameters were measured to confirm the establishment of PCOS models. Hematoxylin-eosin (H&E) staining was performed to observe endometrium morphological change, and western blot and RT-PCR were performed to identify the alteration AMP-activated protein kinase (AMPKα) and SIRT1 proteins and the relative expression of SIRT1 mRNA in endometrial cellular after the intervention of exenatide (EX). Results: The endometrium of PCOS rats appeared to not only the gland number increased but also the gland size enlarged. When the PCOS rats underwent EX treatment, the gland number decreased and the gland size narrowed, the expression of AMPKα and SIRT1 protein increased, and the expression of SIRT1 mRNA level augmented. Conclusion: EX could decrease gland number and narrow gland size in PCOS rat endometrium which may be partly via AMPKα-SIRT1 pathway.
... Takreem et al. (Takreem et al. 2009) (53.3%) and Muzaffar et al. (Muzaffar et al. 2005) (51.9%) found out that the most common complaint in endometrial hyperplasia is menorrhagia which compares favorably with the present study. The commonest age group was found to be 41-50 years in this study which was previously indicated in other studies (Kurman et al. 1985;Takreem et al. 2009;Muzaffar et al. 2005;Rao et al. 2009). In literature (Kurman et al. 2014b), hyperplasia without atypia is said to be more common among perimenopausal women and AH/EIN among peri-and postmenopausal women which correlated well with our findings (Kurman et al. 2014b;Ellenson et al. 2011). ...
Article
Full-text available
Endometrial carcinoma is one of the most common carcinomas affecting women worldwide, and detecting them at the level of precursor lesions can reduce the morbidity and mortality. The aim of this study is to perform a comparative analysis of the two- and four-tier systems on the basis of clinical features and establishe a clinico-pathological correlation. A 5-year study was conducted on histopathologically diagnosed cases of endometrial hyperplasia from the gynecological specimens received in the department of Pathology. The study included 34 cases of endometrial hyperplasia. Hyperplasia without atypia (91.2%) and simple hyperplasia without atypia (82.35%) was the most common type as per the two- and four-tier system, respectively. Hyperplasia without atypia was most common in the fourth to fifth decade of life (54.84%), atypical hyperplasia in the third to fifth decade of life (66.66%), and EIN presented after the sixth decade of life. Hyperplasia without atypia presented most commonly with menorrhagia (64.52%) and atypical hyperplasia/EIN with post-menopausal bleeding (66.66%). Both were more common in multiparous women (87.10 and 66.66%, respectively). Morphologically, variable-sized glands with cystic dilatation (70.6%) and the absence of atypia (91%) was most common. The case of EIN was associated with endometrioid adenocarcinoma. Leiomyoma (3 cases), adenomyosis (2 cases), and endometritis (1 case) were the associated lesions. Abnormal uterine bleeding should raise a suspicion of endometrial hyperplasia, and every specimen received should be examined thoroughly, because histopathological examination is essential to give the diagnosis. Endometrial hyperplasia without atypia was the commonest type diagnosed.
... Out of 74 cases, 59 cases of simple hyperplasia, 10 cases of complex hyperplasia without atypia and 5 cases with atypia were observed. They also showed progression, regression, and persistence of lesion [14]. Similarly in our study, the commonest age group is 4050 years and also found that simple hyperplasia is the commonest endometrial pattern. ...
... Untreated hyperplasia can develop into an endometrioid type of adenocarcinoma; hence, it is important to recognize the precursor lesions. Till date, there are limited studies with respect to the biology of hyperplastic lesions of endometrium documented from India [4]. ...
... Rao et al. [4] carried out a retrospective study in Indian population for 16 years to determine the nature and outcome of proliferative lesions of the endometrium. They reviewed histopathological diagnosis of the endometrial hyperplasia, polyp, and carcinoma, on endometrial biopsy and hysterectomy specimens in the follow-up cases. ...
... Timely treatment can help us provide an environment for the lesion to regress and avoid radical surgeries. Endometrial hyperplasia without atypia may be treated medically or surgically with simple hysterectomy, while the atypical endometrial hyperplasia requires a meticulous intraoperative assessment of the gross pathology or frozen section, and the endometrial carcinoma requires a more extensive procedure of surgical staging [1,4]. ...
Article
Objective To evaluate the clinical as well as histomorphologic features in different cases of endometrial hyperplasia along with its relative occurrence. Materials and Methods A one-and-a-half-year prospective study was conducted on histopathologically diagnosed cases of endometrial hyperplasia in a tertiary care hospital. Apart from relevant clinical findings, histomorphologic details were noted and statistically analyzed. Observations Maximum number (46.5 %) of endometrial hyperplasia occurred in patients of 41–50 years age group. Majority (55.2 %) of the patients were found to be premenopausal. Menorrhagia was the most common (49.6 %) clinical presentation followed by postmenopausal bleeding (30.8 %). Simple hyperplasia without atypia was the most common type (95.6 %) followed by complex hyperplasia without atypia (3.6 %) and complex hyperplasia with atypia (0.8 %), respectively. The study of gland–stroma ratio revealed 65:35 to be the most frequent (34 %) ratio; variable-sized glands with cystic dilatation (60.4 %) was the commonest gland architecture and most of the cases (99.2 %) showed the absence of atypia. Associated histopathological findings included a case each of endometrial adenocarcinoma and undifferentiated endometrial stromal sarcoma along with the common leiomyoma and progesterone effects. Conclusion Menorrhagia was the most common presenting complaint in cases of endometrial hyperplasia. The cases were mostly in the premenopausal age group. Simple endometrial hyperplasia without atypia was the commonest type diagnosed histopathologically. Histopathological examination along with clinical details is essential to give the final opinion regarding the diagnosis.
... [2] Excessive and prolonged levels of estrogenic stimulation results in endometrium hyperplasia, which further progresses to endometrial adenocarcinoma. [3] Hyperplasia most commonly occurs around menopause or in association with persistent anovulation in young women. Hyperestrogenic state could either result from excessive endogenous production or exogenous intake of estrogen. ...
Chapter
Endometrial hyperplasia (EH) is a spectrum of morphological changes ranging from a slightly disordered pattern seen in the late proliferative phase of the menstrual cycle to the irregular proliferation of the endometrial glands with an increase in gland-to-stroma ratio leading to thickening of the endometrium. It encompasses histological subtle and spontaneously reversible proliferative lesions to emerging endometrial carcinoma. As endometrial hyperplasia is the only known direct precursor of endometrial carcinoma, sensitive and accurate diagnosis can reduce the likelihood of development of invasive endometrial carcinoma. Currently, two classifications are in use: the World Health Organization (WHO) 2014 classification and the endometrial intraepithelial neoplasia (EIN) classification. The optimal management of endometrial hyperplasia is the subject of significant debate. Regression of hyperplasia to normal endometrium represents the key to conservative treatment of endometrial hyperplasia. In younger women who desire fertility, medical treatment with progestin is appropriate with extremely close monitoring. In older women who do not wish to retain their uterus, hysterectomy is the treatment of choice. In this chapter, a brief overview of the development of a current understanding of EH will serve to understand their diagnosis and management.