Symptoms of endometrial thickening

Endometrial hyperplasia is mainly caused by endogenous and exogenous stimulation, glandular and interstitial damage of the endometrium, clinically manifested as uterine bleeding, which can be found in women of childbearing age and some menopausal women. Endometrial hyperplasia is mainly a series of morphological and biological evolutionary processes, which mainly occurs during menopause and puberty and is related to excessive secretion of ovarian estrogen or progesterone.

Functional uterine bleeding, the symptoms of functional bleeding are also very critical. It is mainly divided into four types: simple, adenomatous, and some atypical phenomena. In daily life, we must pay attention to the signs of uterine fibroids, which are mainly infections of the body's endometrium.

Macroscopically, the endometrium is generally thickened, up to 0.5 to 1 cm, with a smooth, soft surface. It may also be irregular or polyp-like in shape. Microscopically, it can be divided into 4 types: ① Simple type, in which both endometrial glands and stroma proliferate, with a significant increase in the number of glands, different sizes, and uneven distribution (Figure 13-6). Occasionally, the glands are enlarged into cysts, and the glandular epithelial cells are columnar, lack secretion, and are often arranged in pseudostratified layers. Mitotic figures are common. The interstitial cells are densely packed. ② Cystogenous type, characterized by obvious cystic dilatation of hyperplastic glands. In typical cases, scattered small holes can be seen in the thickened intima with the naked eye, so it is called Swiss cheese hyperplasia. Microscopically, the endometrial glands have various shapes and extremely inconsistent sizes. The small ones are like glands in the early stages of hyperplasia, while the large ones can be several to dozens of times larger in diameter. Both large and small glands are lined with pseudostratified high columnar or cuboidal epithelium and lack secretion.

The interstitial cells are abundant, with scant cytoplasm and darkly stained nuclei. ③ Adenoma-like type, characterized by densely arranged glandular hyperplasia and sparse stroma. The number of glands is far greater than the previous two types, and the structure is more complex. The glandular epithelium proliferates in a papillary manner into the glandular cavity or in a budding manner into the stroma. The stroma is sparse. The glandular epithelial cells are tall columnar, pseudostratified, with vacuolated nuclei, and mitotic figures are common but without obvious atypia. ④ Atypical hyperplasia: The tissue structure is similar to that of adenomatous hyperplasia. The glands are crowded and proliferate in an irregular, branching or budding manner. The stroma is significantly reduced. At the same time, the glandular epithelial cells are atypia, with large nuclei, coarse chromatin, prominent nucleoli, epithelial stratification, loss of polarity, and common nuclear division images. Atypical endometrial hyperplasia is sometimes difficult to differentiate from well-differentiated adenocarcinoma, mainly because the former does not show stromal infiltration. Some people believe that it is a precancerous change of endometrial adenocarcinoma.

The above are the symptoms of endometrial thickening. There are some common symptoms of anovulation and temporary, complex and atypical symptoms during endometrial thickening. Scattered small holes can be seen in the thickened endometrium with the naked eye. It mainly occurs during menopause and puberty and is related to excessive secretion of ovarian estrogen or progesterone. If found, you must go to the hospital for diagnosis and treatment in time.