Pathological changes of endometrium in anovulatory functional uterine bleeding

Functional uterine bleeding is a common gynecological disease, mainly due to abnormal menstruation caused by dysfunction of the nervous system and endocrine system. Anovulatory functional uterine bleeding is one type of this disease. The pathological changes of the endometrium in this type of disease are as follows:

Hyperplastic endometrium

Hyperplastic endometrium is more common, with changes similar to normal proliferative phase, and persists in the premenstrual period.

Adenocystic endometrial hyperplasia

The endometrium is thickened and proliferates in a polypoid manner. The number of glands increases, the glandular cavity is enlarged, and the morphology is different. The glandular epithelium is high columnar and proliferates in a stratified or pseudostratified manner. Interstitial edema, spiral arterioles are hypoplastic, and the microvessels in the endometrium are tortuous, congested, necrotic, or focally hemorrhaged.

Adenomatous endometrial hyperplasia

The number of glands increased significantly, with different sizes and close arrangement in a back-to-back phenomenon. The glandular epithelium proliferated significantly and showed pseudostratification or papillary protrusion into the glandular cavity. The nuclei were large and central, darkly stained, with clear nuclear-cytoplasmic boundaries, and mitosis was occasionally seen.

Atypical endometrial hyperplasia

On the basis of adenomatous proliferation, the glandular epithelium is highly proliferative and shows active mitosis, with heterogeneous nuclei of different sizes, dark staining, unclear nuclear-cytoplasmic boundaries, and imbalanced proportions.

Tips: Hyperplastic endometrium accounts for more than 90% of anovulatory functional uterine bleeding and 30.8%-39.4% of all functional uterine bleeding. Adenomatous and atypical endometrial hyperplasia are precancerous lesions of endometrial cancer and should be taken seriously and treated actively.