子宮内膜増殖症
WordNet
- of or relating to the endometrium
- abnormal increase in number of cells
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/08/09 19:37:46」(JST)
[Wiki en表示]
| Endometrial hyperplasia |
| Classification and external resources |
Micrograph showing simple endometrial hyperplasia, where the gland-to-stroma ratio is preserved but the glands have an irregular shape and/or are dilated. Endometrial biopsy. H&E stain.
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| ICD-10 |
N85.0 |
| ICD-9 |
621.3 |
| DiseasesDB |
4263 |
| eMedicine |
med/3334 |
| MeSH |
D004714 |
Endometrial hyperplasia is a condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus.
Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including obesity, polycystic ovary syndrome, estrogen producing tumours (e.g. granulosa cell tumour) and certain formulations of estrogen replacement therapy. Endometrial hyperplasia is a significant risk factor for the development or even co-existence of endometrial cancer, so careful monitoring and treatment of women with this disorder is essential.
Contents
- 1 Classification
- 2 Diagnosis
- 3 Treatment
- 4 References
- 5 See also
Classification[edit source | edit]
Like other hyperplastic disorders, endometrial hyperplasia initially represents a physiological response of endometrial tissue to the growth-promoting actions of estrogen. However, the gland-forming cells of a hyperplastic endometrium may also undergo changes over time which predispose them to cancerous transformation. Several histopathology subtypes of endometrial hyperplasia are recognisable to the pathologist, with different therapeutic and prognostic implications.[1]
- Endometrial hyperplasia (simple or complex) - Irregularity and cystic expansion of glands (simple) or crowding and budding of glands (complex) without worrisome changes in the appearance of individual gland cells. In one study, 1.6% of patients diagnosed with these abnormalities eventually developed endometrial cancer.[2]
- Atypical endometrial hyperplasia (simple or complex) - Simple or complex architectural changes, with worrisome (atypical) changes in gland cells, including cell stratification, tufting, loss of nuclear polarity, enlarged nuclei, and an increase in mitotic activity. These changes are similar to those seen in true cancer cells, but atypical hyperplasia does not show invasion into the connective tissues, the defining characteristic of cancer. The previously mentioned study found that 22% of patients with atypical hyperplasia eventually developed cancer.[2]
Diagnosis[edit source | edit]
Diagnosis of endometrial hyperplasia can be made by endometrial biopsy which is done in the office setting or through curettage of the uterine cavity to obtain endometrial tissue for histopathologic analysis. A workup for endometrial disease may be prompted by abnormal uterine bleeding, or the presence of atypical glandular cells on a pap smear.[3]
Treatment[edit source | edit]
Treatment of endometrial hyperplasia is individualized, and may include hormonal therapy, such as cyclic or continuous progestin therapy, or hysterectomy.[3]
References[edit source | edit]
- ^ Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) (2002). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.
- ^ a b Kurman RJ, Kaminski PF, Norris HJ (1985). "The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients". Cancer 56 (2): 403–12. doi:10.1002/1097-0142(19850715)56:2<403::AID-CNCR2820560233>3.0.CO;2-X. PMID 4005805.
- ^ a b Howard A Zacur, Robert L Giuntoli, II, Marcus Jurema. Endometrial Hyperplasia. UpToDate Online (subscription required). Retrieved 2007-05-26
See also[edit source | edit]
- Endometrial intraepithelial neoplasia
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Female diseases of the pelvis and genitals (N70–N99, 614–629)
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| Internal |
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Adnexa
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Ovary
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Oophoritis · Ovarian cyst (Follicular cyst of ovary, Corpus luteum cyst, Theca lutein cyst) · Endometriosis of ovary · Ovarian hyperstimulation syndrome · Ovarian torsion · Ovarian apoplexy · Mittelschmerz · Female infertility (Anovulation, Poor ovarian reserve)
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Fallopian tube
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Salpingitis · Hydrosalpinx · Hematosalpinx · Female infertility (Fallopian tube obstruction)
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Uterus
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Endometrium
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Endometritis · Endometriosis · Endometrial polyp · Endometrial hyperplasia · Asherman's syndrome · Dysfunctional uterine bleeding
menstruation: flow (Amenorrhoea, Hypomenorrhea, Oligomenorrhea) · timing (Menorrhagia, Menometrorrhagia, Metrorrhagia) · pain (Dysmenorrhea, PMS)
Female infertility (Habitual abortion)
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Myometrium
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Adenomyosis
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Parametrium
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Parametritis
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Cervix
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Cervicitis · Cervical polyp · Nabothian cyst · Cervical incompetence · Female infertility (Cervical stenosis) · Cervical dysplasia
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General
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Hematometra/Pyometra · Retroverted uterus
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Vagina
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Vaginitis (Bacterial vaginosis, Atrophic vaginitis, Candidal vulvovaginitis) · Leukorrhea/Vaginal discharge · Hematocolpos/Hydrocolpos
Sexual dysfunction (Dyspareunia, Hypoactive sexual desire disorder, Sexual arousal disorder, Vaginismus)
Prolapse (Cystocele, Rectocele, Enterocele, Sigmoidocele, Urethrocele) · Fistulae (Vesicovaginal, Rectovaginal)
Vaginal bleeding
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Other/general
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Pelvic inflammatory disease · Pelvic congestion syndrome
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| External |
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Vulva
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Vulvitis · Bartholin's cyst · Kraurosis vulvae · Vulvodynia
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Clitoral hood or Clitoris
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Clitoral phimosis · Clitorism
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noco/cong/npls, sysi/epon
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proc/asst, drug (G1/G2B/G3CD)
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UpToDate Contents
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English Journal
- Expression of a putative stem cell marker Musashi-1 in endometrium.
- Lu X, Lin F, Fang H, Yang X, Qin L.SourceDepartment of Histology and Embryology, Medical College of Jinan University, Guangzhou, Guangdong, China. tluxye@jnu.edu.cn.
- Histology and histopathology.Histol Histopathol.2011 Sep;26(9):1127-33.
- Aim: Firstly to examine the expression characteristics of Musashi (Msi)-1 in fetal endometrium, reproductive normal endometrium, endometrial hyperplasia and endometrioid adenocarcinoma, next, to focus on exploring the possibility that Msi-1 serves as a marker of the endometrial stem cells in-situ. M
- PMID 21751144
- The effect of tamoxifen and raloxifene on estrogen metabolism and endometrial cancer risk.
- Williams-Brown MY, Salih SM, Xu X, Veenstra TD, Saeed M, Theiler SK, Diaz-Arrastia CR, Salama SA.SourceDepartment of Obstetrics & Gynecology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0587, United States.
- The Journal of steroid biochemistry and molecular biology.J Steroid Biochem Mol Biol.2011 Sep;126(3-5):78-86. Epub 2011 May 10.
- Selective estrogen receptor modulators (SERMs) demonstrate differential endometrial cancer (EC) risk. While tamoxifen (TAM) use increases the risk of endometrial hyperplasia and malignancy, raloxifene (RAL) has neutral effects on the uterus. How TAM increases the risk of EC and why TAM and RAL diffe
- PMID 21600284
Japanese Journal
- (3)子宮体癌における高単位プロゲステロンによる妊孕性温存療法 : 治療効果および安全性,その後の妊娠について,長期観察結果(<特集>第62回学術講演会 シンポジウム1 婦人科癌における妊孕性温存治療(手術および薬物療法))
- 牛嶋 公生
- 日本産科婦人科學會雜誌 62(10), 2107-2114, 2010-10-01
- … As the number of younger women with endometrial carcinoma has increased, fertility-sparing treatment has received much attention. … To clarify the efficacy of fertility-sparing treatment using medroxyprogesterone acetate (MPA) for endometrial carcinoma (EC) and atypical hyperplasia (AH) in young women, we conducted multicenter prospective study for this issue at 16 institutions in Japan. …
- NAID 110007730377
- 子宮内膜細胞診はどこまで組織所見を捉えられるか : 細胞像から組織構築を掴む
- 及川 洋恵,則松 良明,鷲尾 尚子,板橋 育子,藤原 しのぶ,石黒 典子,田勢 亨,東岩井 久,佐藤 信二,伊藤 潔
- 日本臨床細胞学会雑誌 49(4), 297-305, 2010-07-22
- NAID 10026564598
Related Links
- Endometrial hyperplasia is a condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus. Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient ...
Related Pictures
★リンクテーブル★
[★]
- 英
- endometrial hyperplasia
- 関
- 子宮内膜。子宮体癌、子宮内膜肥厚
概念
病因 (NGY.229)
- エストロゲンは内膜上皮と間質細胞の分裂・増殖を促進
- プロゲステロンは内膜上皮の分化を誘導し、間質細胞の分裂・増殖を促進
- プロゲステロンの拮抗のないエストロゲン過剰状態が持続することで上皮の過剰増殖が起こり、内膜が肥厚する。
病型
- 腺腔構造の異型により分類。腺腔が丸い場合には単純型。腺腔が分枝している場合には複雑型。
- 腺の形がおかしい(腺上皮下の間質がほとんどない)、細胞異型が強い、核小体が見える
子宮内膜増殖症の組織型分類
[★]
- 同
- atypical endometrial hyperplasia, simple, AEH-S
- simple atypical hyperplasia, SAH
- 関
- 子宮内膜増殖症, endometrial hyperplasia
[★]
- 英
- endometrial hyperplasia
- 関
- 子宮内膜増殖症
[★]
子宮内膜異型増殖症、異型子宮内膜増殖症
- 関
- endometrial hyperplasia
[★]
単純型子宮内膜異型増殖症
[★]
単純型子宮内膜増殖症
[★]
- 関
- endometria、endometrium
[★]
子宮内膜
- 関
- endometrial、endometrium