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'''For patient information, click [[Endometrial hyperplasia (patient information)|here]]'''
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==Overview==
==[[Endometrial hyperplasia overview|Overview]]==
'''Endometrial hyperplasia''' is a condition of excessive proliferation of the cells of the [[endometrium]], or inner lining of the [[uterus]]. Most cases of endometrial hyperplasia result from high levels of [[estrogen]]s, combined with insufficient levels of the [[progestagen|progesterone-like]] hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including [[polycystic ovary syndrome]] and certain formulations of [[estrogen replacement therapy]]. Endometrial hyperplasia is a significant risk factor for the development of [[endometrial cancer]] so careful monitoring and treatment of women with this disorder is essential.
 
==[[Endometrial hyperplasia classification|Classification]]==
 
==[[Endometrial hyperplasia historical perspective|Historical Perspective]]==
 
==[[Endometrial hyperplasia pathophysiology|Pathophysiology]]==
 
==[[Endometrial hyperplasia epidemiology and demographics|Epidemiology & Demographics]]==
 
==[[Endometrial hyperplasia epidemiology and demographics|Risk Factors]]==
 
==[[Endometrial hyperplasia screening|Screening]]==


==Classification==
==[[Endometrial hyperplasia causes|Causes]]==
Like other [[hyperplasia|hyperplastic]] disorders, endometrial hyperplasia initially represents a [[physiology|physiological]] response of endometrial tissue to the growth-promoting actions of [[estrogen]]. However, the gland-forming cells of a hyperplastic endometrium may also undergo changes over time which predispose them to [[cancer]]ous transformation. Several [[microscopic|histopathology]] subtypes of endometrial hyperplasia are recognisable to the [[pathology|pathologist]], with different therapeutic and [[prognosis|prognostic]] implications.<ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref>


*Endometrial hyperplasia (simple or complex) - Irregularity and cystic expansion of glands (simple) or crowding and budding of glands (complex) without worrisome changes in the appearance of individual gland cells. In one study, 1.6% of patients diagnosed with these abnormalities eventually developed endometrial cancer.<ref name="Kurman">{{cite journal |author=Kurman RJ, Kaminski PF, Norris HJ |title=The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients |journal=Cancer |volume=56 |issue=2 |pages=403-12 |year=1985 |pmid=4005805 |doi=}}</ref>
==[[Endometrial hyperplasia differential diagnosis|Differentiating Endometrial hyperplasia from other Diseases]]==


*Atypical endometrial hyperplasia (simple or complex) - Simple or complex architectural changes, with worrisome (''atypical'') changes in gland cells, including cell stratification, tufting, loss of nuclear polarity, enlarged nuclei, and an increase in [[mitosis|mitotic activity]]. These changes are similar to those seen in true cancer cells, but atypical hyperplasia does not show invasion into the connective tissues, the defining characteristic of cancer. The previously mentioned study found that 22% of patients with atypical hyperplasia eventually developed cancer.<ref name="Kurman">{{cite journal |author=Kurman RJ, Kaminski PF, Norris HJ |title=The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients |journal=Cancer |volume=56 |issue=2 |pages=403-12 |year=1985 |pmid=4005805 |doi=}}</ref>
==[[Endometrial hyperplasia natural history|Natural History, Complications & Prognosis]]==


==Diagnosis==
==Diagnosis==
Diagnosis of endometrial hyperplasia is typically performed though [[curettage]] of the uterine cavity to obtain endometrial tissue for histopathologic analysis. A workup for endometrial disease may be prompted by abnormal uterine bleeding, or the presence of atypical glandular cells on a [[pap smear]].<ref name="UTDOL-EH">[http://www.uptodateonline.com/utd/content/topic.do?topicKey=gen_gyne/13384&type=A&selectedTitle=1~22] Howard A Zacur, Robert L Giuntoli, II, Marcus Jurema, "Endometrial Hyperplasia" from UpToDate Online (accessed 5-26-07)</ref>
[[Endometrial hyperplasia history and symptoms|History & Symptoms]] | [[Endometrial hyperplasia physical examination|Physical Examination]] | [[Endometrial hyperplasia staging|Staging]] | [[Endometrial hyperplasia laboratory tests|Lab Tests]] | [[Endometrial hyperplasia electrocardiogram|Electrocardiogram]] | [[Endometrial hyperplasia chest x ray|Chest X Ray]] | [[Endometrial hyperplasia CT|CT]] | [[Endometrial hyperplasia MRI|MRI]] | [[Endometrial hyperplasia echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Endometrial hyperplasia other imaging findings|Other Imaging Findings]] | [[Endometrial hyperplasia other diagnostic studies#D&C|D&C]]


==Treatment==
==Treatment==
Treatment of endometrial hyperplasia is individualized, and may include [[hormonal therapy (oncology)|hormonal therapy]], such as cyclic or continuous [[progestin]] therapy, or [[hysterectomy]].<ref name="UTDOL-EH">[http://www.uptodateonline.com/utd/content/topic.do?topicKey=gen_gyne/13384&type=A&selectedTitle=1~22] Howard A Zacur, Robert L Giuntoli, II, Marcus Jurema, "Endometrial Hyperplasia" from UpToDate Online (accessed 5-26-07)</ref>
[[Endometrial hyperplasia medical therapy#Hormonal therapy|Hormonal therapy]] | [[Endometrial hyperplasia surgery|Surgery]] | [[Endometrial hyperplasia primary prevention|Primary Prevention]] | [[Endometrial hyperplasia secondary prevention|Secondary Prevention]]


==References==
[[Category:Overview complete]]
{{reflist|2}}


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Revision as of 20:34, 20 January 2012

For patient information, click here

Endometrial hyperplasia
ICD-10 N85.0
ICD-9 621.3
DiseasesDB 4263

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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Screening

Causes

Differentiating Endometrial hyperplasia from other Diseases

Natural History, Complications & Prognosis

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