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Difference between revisions of "Endometrial hyperplasia"
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=Overview= | =Overview= | ||
The | ===WHO endometrial hyperplasia classification of 2014=== | ||
The 2014 WHO system has two categories:<ref name=pmid25797956 >{{Cite journal | last1 = Emons | first1 = G. | last2 = Beckmann | first2 = MW. | last3 = Schmidt | first3 = D. | last4 = Mallmann | first4 = P. | title = New WHO Classification of Endometrial Hyperplasias. | journal = Geburtshilfe Frauenheilkd | volume = 75 | issue = 2 | pages = 135-136 | month = Feb | year = 2015 | doi = 10.1055/s-0034-1396256 | PMID = 25797956 }}</ref> | |||
*Hyperplasia without atypia. | |||
*Atypical hyperplasia/endometrioid intraepithelial neoplasia. | |||
===WHO classification | ===WHO endometrial hyperplasia classification of 1994=== | ||
The WHO system is based on determining: | The 1994 WHO system is based on determining:<ref name=pmid25797956>{{Cite journal | last1 = Emons | first1 = G. | last2 = Beckmann | first2 = MW. | last3 = Schmidt | first3 = D. | last4 = Mallmann | first4 = P. | title = New WHO Classification of Endometrial Hyperplasias. | journal = Geburtshilfe Frauenheilkd | volume = 75 | issue = 2 | pages = 135-136 | month = Feb | year = 2015 | doi = 10.1055/s-0034-1396256 | PMID = 25797956 }}</ref> | ||
# Gland density (normal = ''simple hyperplasia'', high density = ''complex hyperplasia''). | # Gland density (normal/low = ''simple hyperplasia'', high density = ''complex hyperplasia''). | ||
# Presence/absence of nuclear atypia. | # Presence/absence of nuclear atypia. | ||
It consists of four categories: | |||
*[[Simple endometrial hyperplasia]]. | |||
*[[Simple endometrial hyperplasia with atypia]]. | |||
*[[Complex endometrial hyperplasia]]. | |||
*[[Complex endometrial hyperplasia with atypia]]. | |||
===Alternate classifications - overview=== | ===Alternate classifications - overview=== | ||
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#Endometrial intraepithelial neoplasia (EIN). | #Endometrial intraepithelial neoplasia (EIN). | ||
==WHO classification== | ==WHO classification of 1994== | ||
===Management of endometrial hyperplasia=== | ===Management of endometrial hyperplasia=== | ||
*Endometrial hyperplasia with atypia is usually treated with hysterectomy.<ref>URL: [http://www.aafp.org/afp/990600ap/3069.html http://www.aafp.org/afp/990600ap/3069.html].</ref> | *Endometrial hyperplasia with atypia is usually treated with hysterectomy.<ref>URL: [http://www.aafp.org/afp/990600ap/3069.html http://www.aafp.org/afp/990600ap/3069.html].</ref> | ||
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**Progestins + close follow-up ''OR'' hysterectomy. | **Progestins + close follow-up ''OR'' hysterectomy. | ||
===Risk of progression to carcinoma=== | ===Risk of progression to carcinoma as per 1994 system=== | ||
Approximate risk of progression to [[endometrial carcinoma]] - Latta rule of 3s:<ref>Latta, E. January 2009.</ref> | Approximate risk of progression to [[endometrial carcinoma]] - Latta rule of 3s:<ref>Latta, E. January 2009.</ref> | ||
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=WHO system= | ==WHO system of 1994 - detail articles== | ||
Almost all hyperplasia is seen in the context of proliferative-type endometrium. [[Endometrial hyperplasia with secretory changes|Hyperplasia in the secretory-type endometrium]] is extremely rare and something diagnosed by or in consultation with an expert in gynecologic pathology. | Almost all hyperplasia is seen in the context of proliferative-type endometrium. [[Endometrial hyperplasia with secretory changes|Hyperplasia in the secretory-type endometrium]] is extremely rare and something diagnosed by or in consultation with an expert in gynecologic pathology. | ||
==Simple endometrial hyperplasia== | ===Simple endometrial hyperplasia=== | ||
*[[AKA]] ''simple hyperplasia''. | *[[AKA]] ''simple hyperplasia''. | ||
{{Main|Simple endometrial hyperplasia}} | {{Main|Simple endometrial hyperplasia}} | ||
==Simple endometrial hyperplasia with atypia== | ===Simple endometrial hyperplasia with atypia=== | ||
{{Main|Simple endometrial hyperplasia}} | {{Main|Simple endometrial hyperplasia}} | ||
==Complex endometrial hyperplasia== | ===Complex endometrial hyperplasia=== | ||
*Abbreviated ''CEH''. | *Abbreviated ''CEH''. | ||
{{Main|Complex endometrial hyperplasia}} | {{Main|Complex endometrial hyperplasia}} | ||
==Complex endometrial hyperplasia with atypia== | ===Complex endometrial hyperplasia with atypia=== | ||
*[[AKA]] ''complex atypical hyperplasia''. | *[[AKA]] ''complex atypical hyperplasia''. | ||
{{Main|Complex endometrial hyperplasia}} | {{Main|Complex endometrial hyperplasia}} | ||