CHSJ

Curr Health Sci J, vol. 35, no. 1, 2009

Histopathological Study of Epithelial Metaplasias in Endometrial Hyperplasia

[Original paper]

Camelia Firoiu(1), Cristiana Simionescu(2), Diana Stanculescu(3), Florentina Cheznoiu(1), A. Stepan (2)


(1) Laboratory of Pathology, Tg-Jiu;
(2) Pathology Department, UMF Craiova,
(3)Laboratory of Patology, Tg-Carbunesti;


Abstract:

Objective: The aim of this paperwork is a histopathological study focused on the association of endometrial hyperplasia with epithelial metaplasia to evaluate the ethiopathological relation between these conditions. Material and methods: The material we studied was endometrial tissue obtained from biopsies, curetting and hysterectomy specimens from 624 patients investigated in Gynaecologic Ambulatory and hospitalised in Gynaecologic surgery of Emergency Hospital Tg-Jiu and diagnosed with endometrial hyperplasia in a period of 5 years, between 2004 and 2008, cases which were revaluated for epithelial metaplasias. This material was processed by classical technique of paraffin embedding and Haematoxylin-eosin staining in the Laboratory of Anatomopathology in the same hospital. Results: From the 624 endometrial hyperplasias, 333 cases were associated with different variants of epithelial changes as follow: ciliated metaplasia (144 cases), eosinophilic metaplasia (107 cases), squamous /morular metaplasia (78 cases), clear cell metaplasia (23 cases) and mucinous metaplasia (7 cases); these epithelial metaplasias were observed either as unique change (more frequently) or associated each other (most frequently ciliated and eosinophilic). Referred to the histological type of endometrial hyperplasia, the ciliated metaplasia and eosinophilic metaplasia were the most frequent epithelial changes associated with simple hyperplasia without atypia (72.90% and 71.02% respectively). In majority, squamous metaplasia and clear cell metaplasia were found in complex hyperplasia without and with atypia (83.33% and 82.60% respectively), while the mucinous metaplasia was associated with atypical complex hyperplasia in all cases. Conclusions: The increased frequency of association between endometrial hyperplasia and epithelial metaplasia in this study stand for one common etiopatogenic factor of the two lesion, namely persistent estrogenic stimulus. Generally, the most frequent variants of epithelial changes found in endometrial hyperplasias were ciliated and eosinophilic metaplasias. The significant endometrial lesions, namely atypical complex hyperplasia, have shown an increased propensity to associate squamous and mucinous metaplasia; however, these changes cannot be considered indicators of either synchronous or subsequent endometrial carcinoma.


Keywords: epithelial changes (metaplasias); endometrial hyperplasia; histopathology



Corresponding: Camelia Firoiu MD, Laboratory of Pathology, Tg-Jiu


DOI 10.12865/CHSJ.35.01.08 - Download PDF
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