Kelly P, Dobbs S P, McCluggage W G
Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland, UK.
BJOG. 2007 Aug;114(8):944-50. doi: 10.1111/j.1471-0528.2007.01391.x. Epub 2007 Jun 12.
Endometrial polyps are a common cause of abnormal uterine bleeding. Rarely, a hyperplasia, either complex or atypical in type, is identified within a polyp in a biopsy or polypectomy specimen. Currently, it is not known whether the hyperplasia is likely to be confined to the polyp or also involve nonpolypoid endometrium. We aim to assess the likelihood of hyperplasia being confined to an endometrial polyp.
In this study, we identified 32 women from pathology archives in whom endometrial hyperplasia was present within a polyp. The number of endometrial polyps during the study period was 1031 and therefore 3.1% of all endometrial polyps diagnosed during the study period contained a hyperplasia.
A major teaching hospital in the UK.
The biopsies were retrieved from the pathology archives of Royal Group of Hospitals, Belfast, between 2000 and 2006. We traced any follow-up biopsy or hysterectomy specimens to evaluate the status of the surrounding endometrium.
The hyperplasias were complex (n = 23) or atypical (n = 9) in type. In 14 of 27 (52%) women in whom nonpolypoid endometrium was available for histological evaluation, either on the original biopsy or in a follow-up specimen, hyperplasia involved the nonpolypoid endometrium, and in three other women, hyperplasia was present in a polyp in follow-up specimens. Women with atypical hyperplasia in a polyp were slightly more likely to have hyperplasia in the surrounding endometrium than those with complex hyperplasia.
Our study illustrates that the risk of endometrial hyperplasia in a polyp concurrently involving nonpolypoid endometrium is significant. We suggest a strategy for the management of women with hyperplasia identified within an endometrial polyp in a biopsy or polypectomy specimen.
子宫内膜息肉是子宫异常出血的常见原因。在活检或息肉切除标本中，息肉内很少会发现增生，增生类型可为复杂性或非典型性。目前尚不清楚这种增生是局限于息肉内还是也累及非息肉样子宫内膜。我们旨在评估增生局限于子宫内膜息肉的可能性。
在本研究中，我们从病理档案中识别出32例息肉内存在子宫内膜增生的女性。研究期间子宫内膜息肉的数量为1031例，因此在研究期间诊断的所有子宫内膜息肉中有3.1%含有增生。
英国一家主要的教学医院。
活检标本取自2000年至2006年间贝尔法斯特皇家医院集团的病理档案。我们追踪任何后续的活检或子宫切除标本，以评估周围子宫内膜的状况。
增生类型为复杂性（n = 23）或非典型性（n = 9）。在27例可对非息肉样子宫内膜进行组织学评估的女性中，有14例（52%），无论是在原始活检还是后续标本中，增生累及非息肉样子宫内膜，另外3例女性在后续标本的息肉中存在增生。息肉内有非典型增生的女性比有复杂性增生的女性在周围子宫内膜出现增生的可能性略高。
我们的研究表明，息肉内的子宫内膜增生同时累及非息肉样子宫内膜的风险很大。我们提出了一种对在活检或息肉切除标本中发现息肉内有增生的女性的管理策略。
