Uterus - Disordered proliferative hyperplasia

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Uterus

Non tumor

Disordered proliferative hyperplasia

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 4 December 2011, last major update November 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

General
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● Associated with anovulatory cycles, exogenous estrogen therapy; common in perimenopausal and menopausal women
● Difficult to make this diagnosis on biopsy
● Sternberg indicates this diagnosis is “insufficient for diagnosis of hyperplasia”, although WHO calls it a form of simple hyperplasia

Micro description
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● Reflects unopposed estrogen stimulation (i.e. no subsequent progesterone stimulation)
● Resembles normal exuberant proliferative endometrium, but without uniform glandular development (some glands cystically dilated, others have shallow budding)
● Increase of cystically dilated glands, but relatively normal ratio of glands to stroma
● Part of a continuum with endometrial hyperplasia
● Metaplastic changes (ciliated epithelium) are common
● May see endometrial breakdown and hemorrhage with thrombosed, thin walled vessels
● Often plasma cells, but no clinical evidence of infection (Hum Pathol 2007;38:581)

Micro images
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Scattered cystically dilated glands but a low gland density overall

End of Uterus > Non tumor > Disordered proliferative hyperplasia

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