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Endometrial hyperplasia (view source)
Revision as of 02:08, 7 November 2011
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=Overview= | =Overview= | ||
The most widely used system is from the World Health Organization (WHO) | The most widely used system is from the World Health Organization (WHO). | ||
===WHO classification - overview=== | |||
The WHO system is based on determining: | |||
# Gland density (normal = ''simple hyperplasia'', high density = ''complex hyperplasia''). | |||
# Presence/absence of nuclear atypia. | |||
==WHO | ===Alternate classifications - overview=== | ||
Two alternative grading systems exist, that are (currently) not widely used:<ref name=pmid11764378>{{Cite journal | last1 = Dietel | first1 = M. | title = The histological diagnosis of endometrial hyperplasia. Is there a need to simplify? | journal = Virchows Arch | volume = 439 | issue = 5 | pages = 604-8 | month = Nov | year = 2001 | doi = | PMID = 11764378 }}</ref> | |||
#European group of experts (1999). | |||
#Endometrial collaborative group/Harvard (2000). | |||
Both consist of two categories, as opposed to four found in the WHO classification. | |||
====European group of experts classification==== | |||
#Endometrial hyperplasia. | |||
#Endometrioid neoplasia. | |||
====Endometrial collaborative group/Harvard classification==== | |||
#Endometrial hyperplasia. | |||
#Endometrial intraepithelial neoplasia (EIN). | |||
==WHO classification== | |||
===Management of endometrial hyperplasia=== | ===Management of endometrial hyperplasia=== | ||
*Endometrial hyperplasia with atypia is usually treated with hysterectomy.<ref>[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> | ||
**In women who want to maintain fertility it may be treated with progestin + short interval re-biopsies (q3 months).<ref>[http://www.aafp.org/afp/20060801/practice.html http://www.aafp.org/afp/20060801/practice.html]</ref> | **In women who want to maintain fertility it may be treated with progestin + short interval re-biopsies (q3 months).<ref>URL: [http://www.aafp.org/afp/20060801/practice.html http://www.aafp.org/afp/20060801/practice.html].</ref> | ||
*Endometrial hyperplasia without atypia is treated by: | *Endometrial hyperplasia without atypia is treated by: | ||
**Progestins + close follow-up ''OR'' hysterectomy. | **Progestins + close follow-up ''OR'' hysterectomy. | ||