Difference between revisions of "Complex endometrial hyperplasia"

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merge in element of atypical complex hyperplasia
(merge in element of atypical complex hyperplasia)
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{{ Infobox external links
{{ Infobox external links
| Name          = Complex endometrial hyperplasia
| Name          = Complex endometrial hyperplasia
| EHVSC          = 10169
| EHVSC          = 10169  
| EHVSC_mult    = {{EHVSC3|10181|CEH with atypia}}
| pathprotocols  =  
| pathprotocols  =  
| wikipedia      =
| wikipedia      =
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It is generally subdivided into '''complex endometrial hyperplasia without atypia''' and '''complex endometrial hyperplasia with atypia'''.
It is generally subdivided into '''complex endometrial hyperplasia without atypia''' and '''complex endometrial hyperplasia with atypia'''.
===General===
*Usually premenopausal or perimenopausal women.
*Associated with [[obesity]].
*High risk of transformation to [[endometrial carcinoma]] especially when with atypia.


==Microscopic==
==Microscopic==
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*Nuclear enlargement.
*Nuclear enlargement.
*Mitoses common.
*Mitoses common.
*No nuclear atypia.
*+/-Nuclear atypia:
**Round nuclei ~ 2-3x the size of a lymphocyte.
**Grey/translucent chromatin.
**Nucleoli.


Notes:  
Notes:  
*Normal "gland-to-stroma ratio" is 1:3.
*Normal "gland-to-stroma ratio" is 1:3.
*Two "touching" glands may be one gland in section.
*Two "touching" glands may be one gland in section.
*Atypical nuclei often hide between non-typical nuclei, like peg cells in the [[fallopian tube]].


DDx:
DDx:
*[[Complex endometrial hyperplasia with atypia]].
*[[Endometrioid endometrial carcinoma]] - see ''[[endometrial carcinoma versus complex endometrial hyperplasia]]''.
*[[Endometrioid endometrial carcinoma]] - see ''[[endometrial carcinoma versus complex endometrial hyperplasia]]''.


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www:
www:
*[http://www.webpathology.com/image.asp?n=1&Case=568 Endometrial hyperplasia (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=1&Case=568 Endometrial hyperplasia (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=568 Complex endometrial hyperplasia with atypia (webpathology.com)].


==Sign out==
==Sign out==
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- ENDOMETRIAL POLYP WITH ONE ATYPICAL GLAND AND A SQUAMOUS MORULE.
- ENDOMETRIAL POLYP WITH ONE ATYPICAL GLAND AND A SQUAMOUS MORULE.
- SCANT ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY.
- SCANT ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY.
</pre>
===Complex endometrial hyperplasia with atypia===
====Insufficient confluence for carcinoma====
<pre>
ENDOMETRIUM, BIOPSY:
- COMPLEX ENDOMETRIAL HYPERPLASIA WITH ATYPIA, SEE COMMENT.
COMMENT:
The sections show architecturally complex crowded glands with focal
morular squamous metaplasia and focal cribriforming.  Desmoplasia
is not identified. The degree of gland confluence is not considered
sufficient for the diagnosis of endometrial carcinoma. Nuclear atypia
is present focally.
</pre>
====Insufficient extent for carcinoma====
<pre>
ENDOMETRIUM, BIOPSY:
- COMPLEX ENDOMETRIAL HYPERPLASIA WITH ATYPIA, SEE COMMENT.
COMMENT:
The sections show architecturally complex back-to-back glands with focal
morular squamous metaplasia and cribriforming. Desmoplasia is not present.
The extent, i.e. the size of the abnormality, is not considered sufficient
for the diagnosis of endometrial carcinoma.
</pre>
</pre>


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==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Endometrial hyperplasia]]
[[Category:Endometrial hyperplasia]]
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