Hyperplasia is a condition characterized by an increase in the number of cells in a particular organ or tissue (the exception is the tumor tissue). The result of the development of hyperplasia is a noticeable increase in the volume of the organ or neoplasm.
Hyperplasia develops as a result of a variety of influences that stimulate cell proliferation. Thus, tissue growth stimulants, oncogenic substances, can provoke the development of hyperplasia. antigenic irritants, loss for some reason of part of the tissue or organ. As a physiological hyperplasia it is customary to determine the multiplication of the epithelium of the mammary glands during pregnancy. manifestation of glandular hyperplasia of the endometrium in the period before the onset of menstruation and other similar manifestations.
As an example of hyperplasia, which progresses in pathological conditions, one can name an increase in the number of structural elements of the myeloid tissue in patients with certain forms of anemia. Also, hyperplastic processes occur in the lymphatic tissue of the lymph nodes. in the spleen as an immune response in diseases of an infectious nature.
The cells can reproduce indirectly or directly (mitotic or amitotic) division in the process of increasing the protein-synthetic function of the cell. Initially there is an increase in the number of intracellular structures – the so-called intracellular hyperplasia.
Hyperplasia of the endometrium of the uterus is an excessive proliferation of the endometrium (the inner shell of the uterus), which acquires a pathological form. The endometrium suffers changes in the process of the monthly cycle in a woman. The endometrium, due to the influence of hormones on it, increases, expecting a fertilized egg. But if conception still does not occur, it begins to decrease, and the remnants go out with the secretions during menstruation. Then the cycle of changes occurs again.
Symptoms of endometrial hyperplasia.
There are several different types of uterine hyperplasia: glandular. glandular-cystic atypical hyperplasia and endometrium (also called adenomatosis), as well as endometrial polyps (focal hyperplasia.
Hyperplasia of the uterus very often occurs without symptoms at all, but reveals this pathology during a preventive examination with ultrasound. That’s why all women are recommended to undergo gynecological examinations twice a year.
Sometimes endometrial hyperplasia is manifested by periodic uterine bleeding of a dysfunctional nature. Such bleeding is most often manifested after a woman observes a delay in another menstruation, in more rare cases bleeding occurs with a regular cycle. A fairly common phenomenon today is the detection of endometrial hyperplasia in the process of examining patients who turn to specialists in connection with infertility. Hyperplasia of the uterus affects the onset of pregnancy in view of the following factors. First, in patients with such a disease, ovulation may not occur at all because of the presence of hormonal disorders. Secondly, it is almost impossible for the embryo to be implanted in the uterine mucosa, in which pathological changes occurred.
In such a situation, all efforts aimed at treating infertility will fail until the woman undergoes treatment for the main cause of infertility of endometrial hyperplasia.
Causes of endometrial hyperplasia.
This ailment can arise for a variety of reasons. First of all, such are hormonal imbalances, violations of carbohydrate. lipid. as well as other types of metabolism, gynecological disease, the presence in the past of surgical interventions in the uterus and appendages. Quite often, uterine hyperplasia is diagnosed in patients who suffer from concomitant diseases: uterine myoma. endometriosis. hyperestrogenia. mastopathy. polycystic ovary. hypertension. This disease is diagnosed in people with high blood sugar, liver diseases, which provoke a violation of hormonal metabolism.
Diagnosis of endometrial hyperplasia.
The correct diagnosis in this case directly affects the subsequent treatment of infertility, and is also one of the most important factors in the prevention of endometrial cancer.
In the process of diagnosis, a specialist necessarily takes into account the fact that with different types of uterine hyperplasia a diverse rheological picture is observed. Therefore, a careful microscopic study of the structure of the sites of growth of the mucosa, which is obtained in the process of biopsy. With glandular and glandular-cystic hyperplasia, there are approximately the same manifestations, but in the second case they are more pronounced. In the presence of endometrial polyps, hyperplasia has a focal character. If the patient is diagnosed with atypical hyperplasia, then in the uterus there are structural changes in the mucosa, the glands of the endometrium grow more pronounced. In this case, doctors determine the condition of the patient as a precancerous disease of the endometrium.
Especially dangerous type of uterine hyperplasia is its glandular form, which again manifested itself after scraping and shows a pronounced resistance to hormone therapy.
To conduct a diagnosis of endometrial hyperplasia, some common methods are actively used. Most often, ultrasound examination of the pelvis is used for this purpose. According to the results of ultrasound, an experienced specialist can diagnose “polyps of the endometrium” and determine whether there is a thickening of the mucous uterus. However, to date, the accuracy of this method of diagnosis is not more than sixty percent.
Using the method of echogasterosalpingography, it is possible to qualitatively examine the patency of the fallopian tubes. In this process, the doctor sees the screen of the uterus on the screen and determines the presence of features that are typical for endometrial polyps and hyperplasia.
To conduct aspiration or biopsy of the uterine mucosa, it is necessary to begin this process in the second half of the woman’s monthly cycle. To perform this procedure, a specialist should introduce ultrasound under the supervision of a specially used instrument in the uterine cavity. Next, it uses a small amount of tissue, which will become a model for research under a microscope. But an experienced doctor takes into account that this method can also show an incomplete picture of what is happening. After all, biopsy is not always done exactly where there is a focus of hyperplasia.
At the moment, the most accurate way to diagnose uterine hyperplasia is hysteroscopy. This method consists in the following: an optical system is introduced into the uterine cavity, and with it a targeted biopsy is performed. In addition, in the process of hysteroscopy, it is possible to consider and assess the status of the uterine wall.
Treatment of endometrial hyperplasia.
The most important step in the treatment of uterine hyperplasia is the removal of the site of the pathological mucosa. Scraping is performed by a specialist under the supervision of hysteroscopy. After this, necessarily conduct a histological examination of the mucosa. When the focus of hyperplasia is completely removed, hormonal therapy is prescribed. Guided by the presence in the patient of certain symptoms, the specialist prescribes the administration of estrogen-progestational drugs, pure gestagens or agonists of GNP.
The method of treatment of endometrial hyperplasia is selected individually, the process lasts no less than three months. In more rare cases, hormone therapy is taken about six months. To determine how effective the therapy has been, a second study is conducted by biopsy. If there is a severe form of hyperplasia, a specialist can decide about the advisability of removing the uterus.
Hyperplasia of the thyroid gland.
Hyperplasia of the thyroid gland (another name for non-congenital goiter) is a condition in which the gland’s volume increases, while the increase has a non-tumor origin. As a rule, hyperplasia of the thyroid gland is manifested if, for certain reasons, the thyroid gland ceases to produce the right amount of hormones. It is because of a lack of hormones that the thyroid cells begin to divide more quickly, as a result, the mass of the gland increases and hyperplasia occurs. Up to a certain period, hyperplasia of the thyroid gland is a relatively harmless cosmetic ailment. But over time, this formation can develop into a malignant disease of the thyroid gland.
Often hyperplasia of the thyroid gland develops in parallel with the manifestation of other diseases. In other cases, this pathology manifests itself without clear and visible causes. It is accepted to distinguish two forms of this type of hyperplasia: nodal and diffuse. Sometimes hyperplasia develops against the background of euthyroidism. hypothyroidism. hyperthyroidism.
This disease can develop evenly, with an increase in the thyroid gland proportional. But in some cases, the gland increases only on one side. When hyperplasia in the gland can form nodules, but the disease can occur without such a symptom. Cysts can also form. noticeably change the density of the thyroid gland. At some forms of hyperplasia of iron to become softer, at others – more rigidly. There are cases when, due to hyperplasia, the thyroid gland becomes larger in volume three to four times.
It is the enlargement of the gland that is the main symptom of this disease. Later, the patient may also have difficulty breathing, problems with swallowing and passage of food through the esophagus. In the course of the development of the disease there is a decrease or increase in the functions of the gland.
Diagnosis of this disease is carried out by ultrasound examination of the thyroid gland. Thyroid function is also checked using radioactive iodine.
As the prevention of hyperplasia of the thyroid gland, it is important to constantly consume iodized salt.
Prophylaxis of endometrial hyperplasia.
The most important measures to prevent hyperplasia is an active fight against excess weight. avoidance of stressful situations, immediate treatment of manifested violations of the monthly cycle. A regular gynecological examination of women is important.
In some cases, young women, the doctor can recommend hormonal medications for prevention, which reduce the risk of hyperplasia, as well as endometrial cancer. Every woman should realize that in case of manifestations of uterine bleeding, a specialist should be treated immediately.