Endometrial hyperplasia is an overgrowth of endometrial glands, with different shapes and sizes, which causes increased endometrial thickness which results in a greather gland / stroma ratio than observed in normal endometrium.
The term endometrial hyperplasia includes different pathologies that have the common feature to increased endometrial thickness. Some of these pathologies have virtually no potential for malignancy while others are clearly premalignant lesions. The pathological diagnosis is the key to the diagnosis of this entity.
Little is known on the actual incidence of endometrial hyperplasia although it is estimated to affect about 8/1000 in asymptomatic menopausal patients and 15% of patients with postmenopausal bleeding. There are different classifications, perhaps the most accepted is that of the International Society of Gynecological Pathologists that defines the following types:
1-Simple hyperplasia without atypia: Glandular dilatation and increased evidence glands and stroma.
2-Complex hyperplasia without atypia: Great growth of the endometrial glands with little stroma. The distribution pattern is irregularly glandular.
3-Simple hyperplasia with atypia: There are atypical cells present in the lining of the glands.
4-Complex hyperplasia with atypia: pattern of complex hyperplasia with atypical cells in the lining of the glands.
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