Patient's question:
What is the difference between endometrial hyperplasia and endometritis? First question supplement: Does endometrial hyperplasia affect pregnancy? How should it be treated?Doctor's answer:
Hello: Endometrial hyperplasia is clinically characterized by dysfunctional uterine bleeding, with main symptoms including irregular menstruation, prolonged menstrual periods, and excessive menstrual flow. Most cases occur during perimenopause or adolescence. Its occurrence is related to excessive secretion of estrogen by the ovaries and a lack of progesterone.Lesions
Grossly, the endometrium is generally thickened, reaching 0.5–1 cm in thickness, with a smooth, soft surface, or it may appear irregular or polypoid. Microscopically, it can be divided into four types:
① Simple type: Both endometrial glands and stroma are hyperplastic. Glands are markedly increased in number, varying in size and distribution. Occasionally, glands expand to form cysts, with columnar glandular epithelial cells lacking secretion, often arranged in pseudostratified layers. Mitotic figures are common. Stroma cells are arranged tightly.
② Cystic adenomatous type: Characterized by markedly cystic expansion of hyperplastic glands. In typical cases, grossly, small holes are seen in the thickened endometrium, hence it is called Swiss cheese-like hyperplasia. Microscopically, endometrial glands vary in shape and size, with smaller glands resembling those in the early proliferative phase and larger glands having diameters several to tens of times greater. Both small and large glands are lined with pseudostratified tall columnar or cuboidal epithelium, lacking secretion. Stroma cells are abundant, with little cytoplasm and deeply stained nuclei.
③ Adenomatoid type: Characterized by densely arranged hyperplastic glands and sparse stroma. The number of glands is much greater than in the previous two types, and their structure is more complex. Glandular epithelial cells proliferate papillary inward into the glandular lumen or outward into the stroma. Stroma is sparse. Glandular epithelial cells are tall columnar, pseudostratified, with vacuolated nuclei.