How to judge endometrial hyperplasia and pay attention to its five major characteristics

Endometrial hyperplasia is a common gynecological disease in women, and there are also many symptoms after its appearance. It is not only necessary to judge the symptoms reasonably, but also to undergo timely examination.

Types of endometrial hyperplasia

1. Simple hyperplasia: Endometrial gland and interstitial hyperplasia, with a significant increase in gland size and uneven distribution. Occasionally, the gland expands into a cyst, and the glandular epithelial cells are columnar and lack secretion, often arranged in a pseudostratified pattern. Nuclear fission is common. Interstitial cells are tightly arranged. The probability of developing endometrial cancer is only about 1%.

2. Complex hyperplasia: Gland hyperplasia is obvious, crowded, and structurally complex, with adjacent glands appearing back-to-back. Due to glandular epithelial hyperplasia, it can grow in a papillary or mesenchymal manner into the glandular cavity. Due to significant glandular hyperplasia, the stroma decreases, and about 3% can develop into endometrial adenocarcinoma.

3. Atypical hyperplasia: refers to glandular hyperplasia with atypical cells. In the technique of simple or complex hyperplasia, it is manifested as glandular epithelial cell proliferation, increased hierarchy, cell polarity disorder, increased volume, increased nucleocytoplasmic ratio, deep nuclear infection, and mitotic figures. Atypical hyperplasia of the endometrium can sometimes be difficult to differentiate from well differentiated adenocarcinoma, with the main distinguishing point being the absence of interstitial infiltration in the former. Some people believe that this is a precancerous change in endometrial adenocarcinoma.

Symptoms of endometrial hyperplasia

1. The increase in vaginal discharge is mainly due to the increased secretion of endometrial glands, which are generally thin watery, light yellow, and bloody.

2. With excessive menstruation, the menstrual cycle remains regular, but the menstrual volume doubles and the bleeding period significantly prolongs. Only a very small number of patients suffer from anemia due to excessive bleeding, which may be caused by endometrial thickening and inflammation congestion. Irregular bleeding is rare, and sometimes it can stop bleeding for several hours or for 1-2 days.

3. Dysmenorrhea often occurs in nulliparous women, but severe dysmenorrhea is rare. The endometrium is too thick, which may hinder normal tissue degeneration and necrosis, and stimulate excessive spasmodic contractions of the uterus.

4. Pain in the pelvic area, with approximately 40% of patients reporting lower abdominal distension and pain during menstrual intervals, as well as lumbosacral pain

5. Ovarian hormone disorders can easily cause abnormal endometrial thickening, known as endometrial hyperplasia, due to the stimulation of the endometrium by a large amount of estrogen. The clinical manifestation is irregular and excessive abnormal uterine bleeding. Patients may experience persistent bleeding after prolonged amenorrhea, which may be suspected of miscarriage in clinical practice, or may manifest as shortened cycles and prolonged periods, with bleeding lasting up to one month. The symptoms of abnormal endometrial thickening are manifested as endometrial thickening, with a thickness ranging from 3 to 12 millimeters, and some even reaching 20 millimeters. The endometrium is grayish white or light yellow, with a flat or polyp like protrusion on the surface, which can be accompanied by edema. On the section, there are cystic sutures formed by dilated glands.