Endometrial Hyperplasia : Differential Diagnosis
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Endometrial Hyperplasia (EH) - Differential Diagnosis: Disordered proliferative endometrium and nonatypical EH may be difficult to separate from each other. The two often coexist, usually in the setting of anovulatory cycles. EH shows increased gland-to-stroma ratio. Disordered proliferative endometrium shows apoptosis, stromal breakdown, and glandular irregularity but no increase in glandular density.
Cystic Atrophy: Both cystic atrophy and nonatypical EH may have cystically dilated glands. Curettage specimens with EH generally have abundant glandular material, whereas cystic atrophy generates scant dilated glands. Atrophic glands are lined by a single layer of low cuboidal epithelium lacking mitotic figures. The glands have compact or collagenous stroma. Hyperplastic glands are lined by columnar epithelium and show nuclear pseudostratification with numerous mitoses and apoptotic cells.
Image source: Nephron, CC BY-SA 3.0, via Wikimedia Commons
Cystic Atrophy: Both cystic atrophy and nonatypical EH may have cystically dilated glands. Curettage specimens with EH generally have abundant glandular material, whereas cystic atrophy generates scant dilated glands. Atrophic glands are lined by a single layer of low cuboidal epithelium lacking mitotic figures. The glands have compact or collagenous stroma. Hyperplastic glands are lined by columnar epithelium and show nuclear pseudostratification with numerous mitoses and apoptotic cells.
Image source: Nephron, CC BY-SA 3.0, via Wikimedia Commons
