441
Endometrial Hyperplasia
and Carcinoma
Chapter 44
Janos L. Tanyi, MD, PhD
❍ The World Health Organization classifies endometrial hyperplasia based on what two factors?
(1) Simple or complex glandular/stromal architecture.
(2) The presence or absence of cytologic atypia.
❍ What is the best predictor that endometrial hyperplasia will progress to endometrial carcinoma?
The presence or absence of cytologic atypia.
❍ What is the endocrinologic milieu for the development of endometrial hyperplasia?
Unopposed estrogen.
❍ What other common risk factors have been correlated to the development of endometrial hyperplasia?
- Polycystic ovary (PCO) syndrome
- Obesity
- Diabetes mellitus
- Late menopause (after age 55)
- Nulliparity
❍ Which ovarian steroid hormone promotes growth of the endometrium?
Estrogen.
❍ Which ovarian steroid hormone promotes differentiation of the endometrium?
Progesterone.
❍ What percentage of women with atypical hyperplasia have coexistent endometrial cancer at the time of
hysterectomy?
Up to 43%.