Complex Hyperplasia
Complex Hyperplasia

•  The cells lining this complex gland are pseudostratified.

•  The nuclei are elongated and hyperchromatic.

•  Nucleoli are not prominent.

•  The cells retain in general their orientation to the lumen.


(Image Contrib. by:UCHC)(Description by: Melinda Sanders, M.D.)
T84000M72420
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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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• Current literature from PubMed at National Library of Medicine


Synopsis by: Melinda Sanders M.D., UCHC
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