endometrial adenomatosis - is atypical (diffuse or focal), endometrial hyperplasia, which has the character of a precancerous condition.
called precancerous pathological process with varying degrees of probability to go into cancer.Precancerous hyperplastic processes can often regress and only 10% of patients are transformed into cancer.The presence of such a possibility requires that physicians and patients to treat this disease very seriously.
All hyperplastic processes in the endometrium are born with the assistance of hormonal dysfunction and appear uterine bleeding and infertility.The decisive role in their appearance belongs hyperestrogenism.Under the influence of an excess of estrogen in the endometrium occur qualitative and quantitative structural changes that lead to uncontrolled growth and thickening of its internal structures.Depending on the expense of cell type, this process is implemented, allocate several types hyperplastic processes.If the share of
If hyperplastic process covers the entire surface of endometrial hyperplasia is diffuse.Diffuse adenomatosis develops against the background of diffuse hyperplastic process.When the form of focal hyperplasia endometrial tissue grows in a limited area, and eventually begins to "bulge" in the uterus, acquiring the form of a polyp.Focal adenomatosis is an endometrial polyp with elements of atypia.
When endometrial adenomatosis used surgical treatment.On prognosis affect the age of the patient, the nature of hormonal disorders, neuro-endocrine related diseases and the immune system.
Sometimes the doctor asks the patient, differ adenomatosis uterine and endometrial adenomatosis.In fact the two terms denote the process in the presence of atypical uterus.Because there are multiple layers of the uterus, and atypical process affects only the inner layer (the endometrium), the term adenomatosis uterus is not correct.
Fibrous adenomatosis there is no diagnosis.As the name of the pathological fibrotic process adenomatosis also does not make sense: fibrosis expand elements of the connective tissue, with adenosis - glandular, if the process is mixed, suggest fibrocystic hyperplasia.
Diagnosis "adenomatosis" is not specific, and is used not only in relation to the uterus.For example, breast adenomatosis has nothing in common with the atypical endometrial process.Adenomatosis breast disease (Reclus) is the result of benign multiple small cysts in the breast.
reasons endometrial adenomatosis
reasons endometrial adenomatosis similar reasons, endometrial hyperplastic processes, against which there is atypical cell transformation.No significant causes of endometrial adenomatosis not.None of the study of the causes of hyperplastic processes is not guaranteed trigger in the development of endometrial atypical, but the combination of unfavorable factors increases the risk of its occurrence.
There is no doubt that the leading role in the development of hyperplastic processes in uterus belongs to hormonal disorders, affecting all parts of the body work of neuro-humoral regulation.Physiological cyclical changes in the uterus occur with the participation of estrogen and progestogen.Under the influence of estrogen inner mucosal layer of the uterus (the endometrium) increases in volume and progestins do not give him too to grow and contribute to its timely rejection.If estrogen is too much growth of the endometrium becomes uncontrollable character.
Reasons hyperestrogenism can serve as a violation of hormonal function of ovaries, leading to anovulation.Lack of ovulation cycle makes single-phase and provokes abnormal endometrial hyperplasia.
Polycystic ovaries is accompanied by chronic anovulation, and can serve as a favorable occasion for the development of endometrial hyperplasia.
Uncontrolled hormonal drugs can cause hormonal disturbances leading to endometrial hyperplasia.
combination hyperestrogenism, extragenital pathology and neuroendocrine disorders in the body increases the chances of developing endometrial adenomatosis.For example, marked obesity in combination with hypertension increases the risk of endometrial cancer is 10 times.
liver is responsible for the disposal of estrogen, so the liver and / or biliary tract is sometimes hyperestrogenia.
Against uncontrolled proliferation of the inner layer of the uterus may appear abnormal cells that form the basis of endometrial adenomatosis.They called atypical cells that did not resemble the surrounding tissue cells.
symptoms of endometrial adenomatosis
Because endometrial adenomatosis characterized by the appearance of atypical cells, it has distinctive symptoms, the presence of cellular atypia can not be confirmed without laboratory testing.
In the initial stages of the diagnostic process, establish the presence of hyperplastic and then refined his character.
ultrasound scanning using transvaginal probe helps to identify changes in endometrial thickness and structure of the diffuse or focal character.
Diffuse endometrial adenomatosis has no distinctive signs of ultrasound and visualized similarly diffuse hyperplasia.
Focal endometrial adenomatosis is a polyp with atypical cellular changes ultrasound reveals the presence of a polyp, but can not determine the nature of cellular changes.
priority importance in the diagnosis of endometrial adenomatosis is complete histological study scraping the mucous layer of the uterus.In the laboratory study the cellular composition and character of structural changes is determined by the degree of atypia and its severity.Curettage allows us to provide material for subsequent laboratory analysis.Since the total evacuation of the mucous membrane of the uterus is possible only if the visual inspection, scraping is done with the assistance of hysteroscopy.
Treatment of endometrial adenomatosis
Therapy adenomatosis start with mechanical removal of endometrial changes.A study for diagnostic curettage surgery allows for the elimination of the source of pathological changes.
After careful histological examination determined a plan for further treatment.The amount of therapeutic measures is determined individually for each patient, it includes hormone therapy and / or surgery.
young patients often held hormone therapy.The patients in pre- and postmenopausal hormone therapy along with a radical surgical removal of the uterus (sometimes with appendages) is more appropriate.
earlier revealed endometrial adenomatosis, the less the risk of cancer.