Pathological changes of endometrium in patients with anovulatory functional uterine bleeding

Anovulatory functional uterine bleeding refers to irregular uterine bleeding caused by neuroendocrine system dysfunction, which is more common in adolescence and menopause. The pathological changes of the endometrium in patients with anovulatory functional uterine bleeding are as follows:

Hyperplastic endometrium

Clinically, different types of proliferative endometrium account for more than 90% of anovulatory functional uterine bleeding and 30.8-39.4% of all functional uterine bleeding. Histological changes are the same as those in the normal proliferative phase, but they persist in the premenstrual period.

Adenocystic endometrial hyperplasia

Endometrial hypertrophy is polypoid, with an increased number of glands and enlarged glandular cavities, but with different shapes and a Swiss cheese-like structure. The glandular epithelium is high columnar and proliferates in a stratified or pseudostratified form. There is interstitial edema, hypoplastic spiral arterioles, and tortuosity, congestion, necrosis, or focal hemorrhage of the microvessels in the surface layer of the endometrium.

Adenomatous endometrial hyperplasia

It is a precancerous lesion of endometrial cancer. The number of glands increases significantly, the sizes vary, and they are closely arranged back to back. The glandular epithelium proliferates significantly and is pseudostratified or papillary, protruding into the glandular cavity. The nucleus is large and central, darkly stained, with clear nuclear-cytoplasmic boundaries, and mitosis can occasionally be seen.

Atypical endometrial hyperplasia

It is a precancerous lesion of endometrial cancer. On the basis of adenomatous proliferation, the glandular epithelium is highly proliferative and has active mitosis, nuclear heterogeneity, different nuclear sizes, deep staining, unclear nuclear-cytoplasmic boundaries, and imbalanced proportions.