| • The single gland illustrated has a very complex architecture.
• There are multiple lumens which interconnect.
• The cells are tall columnar and some are piled up on top of each other.
• The cells in general do retain their orientation to the lumen. |
| Complex Hyperplasia |
| Etiology |
•associated
with unopposed estrogen use •may be exogenous (non-cycled estrogens) but generally •endogenous due to peripheral aromatization of adrenal
androgens by adipose in obese women •also associated with granulosa cell tumors and other estrogen producing ovarian tumors as well as polycystic ovary
syndrome |
| Pathogenesis |
•estrogen drives continued proliferation of the
endometrium •in the absence of progesterone maturation of the endometrium
and spiral arteries never occurs, nor does regular menses |
| Epidemiology |
•obese post-menopausal
women •may also have diabetes and hypertension (classic triad) |
| Clinical |
•asymptomatic or
post-menopausal bleeding |
| General Gross Description |
•plush,
thick, tan endometrium measuring up 1.0 cms |
| General Micro Description |
•glands exhibit crowding
and often show budding •pseudostratified nuclei with mitotic activity •cells retain orientation to the lumen •cell nuclei have small nucleoli and normal chromatin |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1057-8
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