This document discusses endometrial hyperplasia, a condition characterized by an excessive proliferation of endometrial glands. It can progress to endometrial carcinoma if left untreated, making atypical hyperplasia a premalignant lesion. Risk factors include unopposed estrogen exposure from sources like estrogen therapy, obesity, or hormone-secreting tumors. The document classifies hyperplasia into simple, complex, and atypical subtypes based on histological features and lists their risks of progression to cancer, with atypical forms having the highest risk.

2.  Proliferation of endometrial glands = >normal
gland-to-stroma ratio
 Clinical signifance is its progression to
endometrial carcinoma = endometrial
hyperplasia with atypia is considered a
premalignant lesion

3.  Unopposed action (by progesterone) or
excess of oestrogen action on uterus
 Oestrogen-growth and vasculization
(proliferative endometrium)
 Progesterone- glandular secretion (secretory
endometrium)

4.  Estrogen replacement therapy – exogenous
unopposed estrogen
 Tamoxifen therapy – estrogenic effect on
endometrium
 Polycystic ovarian syndrome- anovulation
 Chronic anovulatory cycles
 Perimenopause period
 Oestrogen-secreting tumors of the ovary
 Obesity- aromatization of androgens in adipose
tissue

5. TYPE OF HYPERPLASIA PROGRESSIONTO CANCER
SIMPLE ( CYSTICWITHOUT ATYPIA) 1
COMPLEX (ADENOMATOUS WITHOUT
ATYPIA)
3
ATYPICAL
SIMPLE (CYSTICWITH ATYPIA) 8
COMPLEX (ADENOMATOUS WITH
ATYPIA)
29
General features of Atypia: glands with increased nuclear/cytoplasmic ratio;
irregular shape; size of nuclei; mitotic bodies; loss of polarity

6. •Increase in glands
•Increase in stroma
•Glands vary in size,
cystically dilated

7. •Glands closely
packed
•Complex
pattern
•Stroma scanty

8. •Cystically dilated
glands with
abundant stroma
•Features of atypia

9. •Closely packed
glands
•Complex pattern
•Features of atypia