Title: Histopathological Evaluation of Hyperplastic Endometrial Lesion based on New WHO classification
Authors: Dr Shikha Ghanghoria, Dr C. S. Chhatrasal, Dr Varsha Argal
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.117
Abstract
Introduction: Endometrial hyperplasia is defined as an increase in the proliferation of endometrial glands relative to stroma, resulting in increased gland to stroma ratio. It is most commonly occurred due to unopposed oestrogen action. In recent past the most widely used system divided endometrial hyperplasia into four categories: simple hyperplasia without atypia; complex hyperplasia without atypia; simple atypical hyperplasia; complex atypical hyperplasia. Recently WHO collapse the four categories into two as non atypical hyperplasia and atypical hyperplasia (also referred as endometrial intraepithelial neoplasia).
Aims: 1) To study comparison between the old and new WHO classification of endometrial hyperplasia.
2) To find out the age wise incidence of these lesions.
3) To estimate the incidence of benign and malignant lesions.
Methods and Material: Retrospective study of cases of endometrial lesions diagnosed as endometrial hyperplasia in M.Y. hospital Indore during 10 year duration. The cases with endometrial hyperplasia were reclassified according to new WHO classification.
Results: Among 600 cases of endometrial hyperplasia 94% cases are of non atypical hyperplasia while 6% cases are of atypical hyperplasia. Majority of the cases are between 41 to 60 year of age. 35% atypical hyperplasia cases they turned out to be malignant while only 0.5% cases without hyperplasia are converted to malignancy.
Conclusions: Recently WHO classified endometrial hyperplasia as non atypical and atypical hyperplasia (endometrial intraepithelial neoplasia). It is better than old one as it represents an important simplification for clinical practice, particularly with regard to choice of treatment. Non atypical hyperplasia are treated conservatively while for atypical hyperplasia hysterectomies are done.
Keywords: Endometrial Hyperplasia, Endometrial Carcinoma, New WHO Classification
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