- Normal to slightly increased gland to stromal ratio
- Proliferative endometrium
- Cystically dilated glands of variabe sizes (diffuse compared to a few in disordered proliferative endometrium)
- Oval nuclei maintaining orientation to basement membrane
*simple hyperplasia is due to unopposed/prolonged oestrogen exposure. A diffuse process. Features of prolonged oestrogen exposure include pseudo-decidualisation and cystic dilatation of glands.
- Increase in the gland to stromal ratio with glandular crowding
- More focal
- Nuclear rounding
- Presence of nucleoli
- Nuclear stratification
- Loss of polarity
- Nuclear atypia should be assessed carefully in areas without metaplasia (ie ciliated cell metaplasia)
My approach to the interpretation of endometrial biopsies and curretttings. McCluggage. J Clin Pathol. 2006 August; 59(8): 801–812.