Hyperplasia is a condition characterized by an increase in the number of cells in a tissue or organ (excluding tumor tissues). The result of the development of this disease is a neoplasm or a noticeable increase in the size of the organ.
Hyperplasia develops after a variety of influences that affect the reproduction of stimulating cells. Thus, antigenic irritants, oncogenic substances, tissue growth stimulants, or the loss of an organ or part of a tissue for any reason can provoke development. Physiological hyperplasia is the growth of the epithelium of the mammary glands during pregnancy, the manifestation of glandular hyperplasia before or during menstruation, and other similar manifestations.
As an example of hyperplasia progressing in pathological conditions, one can name an increase in the volume of structural elements in patients with certain forms of anemia of myeloid tissue. In addition, hyperplastic processes can occur in the lymphoreticular tissue of the lymph nodes, as an immune response in the spleen, in the case ofinfectious diseases.
Variety of shapes
In medicine, there are several main types:
- Physiological hyperplasia. Tissue proliferation occurs, which is functional or temporary. For example, breast hyperplasia, during lactation or during pregnancy.
- Pathological hyperplasia. Due to a number of provoking factors, tissue proliferation occurs.
In addition, this disease can be focal, diffuse and polyposis:
- In the focal form, there is a clear localization of the process in the form of separate sections.
- Diffuse hyperplasia affects the surface of the entire layer.
- The polyposis form is characterized by uneven growth of the connecting elements. In this case, hyperplasia can provoke the development of malignant formations and cysts.
Diffuse thyroid hyperplasia
This disease occurs in the case of a compensatory reaction of the thyroid gland to a lack of iodine. At the same time, the term "diffuse" means that the pathology affects the entire organ: its size increases due to the multiplication of gland cells in order to maintain the secretion of thyroid hormones that promote metabolism, increase oxygen uptake, and maintain energy levels.
The thyroid gland needs iodine to maintain its hormonal activity. Lack or lack of iodine intake contributes to the growth of gland cells and can subsequently lead to its dysfunction.
Hyperplasiaadrenal glands
This disease can be nodular or diffuse. It accompanies unchanged adrenal tissue in cases of pineal tumor and Cushing's syndrome. In adults, this form of hyperplasia, especially the left-sided one, is very difficult to recognize by ultrasound and remains the subject of study by MRI and CT.
Sometimes diffuse hyperplasia of the adrenal glands is accompanied by an increase in organs with the preservation of the normal appearance of the glands - in the form of hypoechoic formations surrounded by fatty tissue. In the case of nodular hyperplasia in the area of the "fat triangle" one can see rounded, homogeneous hypoechoic formations. They are quite difficult to distinguish from an adenoma by an echographic picture.
Prostate gland - benign hyperplasia
About 85% of men over 50 years of age are prone to this disease. Benign prostatic hyperplasia is characterized by the formation of several small nodules (or one) on the prostate, which, gradually spreading, begin to put pressure on the urethra, which subsequently causes difficulty with urination.
This disease does not cause metastasis, this factor distinguishes it from prostate cancer, so it is called benign hyperplasia. However, it does not have a clear cause and is usually associated with male menopause.
Uterine endometrium
Hyperplasia is a benign increase in the thickness and volume of the inner lining of the uterus. May occur inas a result of the reproduction of both glandular and other tissue cells. This disease can lead to disruption of the functional activity of the endometrium (problems with conception, menstrual disorders).
Under normal conditions, the endometrium under the influence of estrogen grows in the first period of the cycle, under the influence of progesterone in the second period of the cycle is restrained. With pathology, the growth of the endometrium occurs uncontrollably, it is able to capture both the entire inner shell and individual parts (focal hyperplasia).
Varieties of endometrial hyperplasia
The predominance of some elements in the growing endometrium stands out:
- Glandular hyperplasia. Endometrial glands overgrow.
- Polypous hyperplasia. There is a focal growth of the endometrium, which has a glandular, glandular-fibrous, and fibrous character. This type of hyperplasia rarely becomes malignant, but can serve as the basis for the development of gynecological diseases.
- Adenomatous hyperplasia with atypical cells, precancerous. In this case, the transformation into cancer of this type of hyperplasia can reach about 10%.
- Glandular cystic hyperplasia. Glands and cysts grow about the same.
Causes of occurrence
Today, the main cause of this disease is the excess of the physiological level of estrogen with a relative lack of progesterone. To suchmay result in:
- Transitional age with hormonal imbalance and hormonal surges.
- Female obesity.
- Polycystic ovary syndrome.
- Menopause.
- Taking estrogen-containing drugs without taking progesterone.
Very often, endometrial hyperplasia (reviews of experts confirm this) occurs in women before menopause and in young nulliparous girls.
Associated diseases that increase the manifestation of hyperplasia are problems with the adrenal glands and breasts, thyroid disease, both types of diabetes mellitus, and hypertension. Factors such as:can also lead to the development of hyperplasia
- Heredity for genital diseases.
- adenomynosis.
- Uterine fibroids.
- Abortions and curettage.
- Inflammatory processes of the genitals.
Causes of development and types of glandular endometrial hyperplasia
Main causes of glandular hyperplasia:
- Anovulation.
- Overweight.
- Presence of follicular cysts.
- Mopa.
Also dangerous is follicle persistence syndrome, glycemia and granulosa cell tumors.
Lack of treatment and late diagnosis of this disease is fraught with such a dangerous consequence as the development of endometrial cancer. Basically, at risk are girls suffering from atypical ademonatous hyperplasia, and women in the period after menopause. It is focal and diffusehyperplasia is a precancerous form of this disease.
Other forms of endometrial hyperplasia are considered to be extensive glandular epithelium, cystic enlarged glands, and glandular cystic hyperplasia.
Symptoms
In most cases, glandular hyperplasia occurs without pronounced clinical symptoms. In this case, dysfunctional uterine bleeding caused by a violation of the menstrual cycle (delayed menstruation) is considered a common manifestation. These bleedings can be both profuse and prolonged, and blood loss can be profuse or moderate. As a result, anemic symptoms develop: loss of appetite, fatigue, weakness.
Between periods, you can observe spotting. Quite often, infertility occurs in women due to anovulation. That is, it is infertility that is the reason for going to the doctor, who subsequently diagnoses this disease. Symptoms also include pain in the lower abdomen.
Glandular hyperplasia can be diagnosed by diagnostic curettage, which is performed just before menstruation. Quite often, ultrasound and hysteroscopy are used in the diagnosis.
Hyperplasia focal
Focal hyperplasia (reviews of experts indicate this) can threaten cancer and infertility. A mild or asymptomatic course allows you to detect this disease only during an ultrasound scan or during a gynecological examination.
Local hyperplasia usually develops after a hormonal disorder, after suffering somatic diseases and abortions, or against the background of glandular hyperplasia.
Focal hyperplasia of the uterine epithelium is diagnosed based on the following symptoms:
- bleeding after menstruation stops;
- acyclic or cyclic menstrual irregularities.
Treatment of this disease is carried out in two main ways:
- Medication method - with the help of special drugs, including hormonal ones.
- Surgical or operative method - by scraping the uterine cavity.
Diagnosis of endometrial hyperplasia
The basis for the diagnosis of this disease is an examination by a gynecologist, instrumental and laboratory studies.
The main diagnostic methods include:
- Ultrasound of the appendages and uterus with a vaginal probe.
- Hysteroscopy with sampling for histological examination.
- Diagnostic curettage of the uterine cavity.
- If it is necessary to clarify the type of hyperplasia, an aspiration biopsy is performed.
One of the most important laboratory tests is the determination of the serum levels of sex hormones and the thyroid gland, as well as the adrenal glands.
It is important to remember that any form of hyperplasia needs accurate diagnosis andrevealing the true cause that led to the increase in tissue.
Treatment
If hyperplasia has been diagnosed, treatment is carried out immediately. The method is selected based on the manifestations of the disease and the age of the patient.
The most effective way is diagnostic curettage or hysteroscopic removal of endometrial diffuse process.
If the treatment process is multi-stage, then, first of all, an emergency or planned curettage is carried out. The first option is used for anemia or bleeding.
Once the histology results are available, the specialist may prescribe the following treatments:
- Gonadotropin antagonist drugs are prescribed at the age of over 35.
- Intrauterine device "Mirena" with gestagens.
- In the second period of the cycle, progestin preparations are prescribed ("Dufaston", "Utrozhestan").
- In order to non-surgical stop bleeding in girls at a young age, it is allowed to use oral contraceptives in fairly large doses.
- Combined oral contraception ("Regulon", "Yarina", "Janine") is prescribed for 6 months with the traditional regimen.
The drugs mentioned above create an effect similar to menopause, but it is reversible.
After curettage for another six months, control is carried out, if there is a recurrence of the adenomatous form of hyperplasia, then removal of the uterus is indicated. Under otherrecurrent forms and the ineffectiveness of other methods of treatment, artificial destruction of the endometrium (ablation) is performed.
Prognosis and complications
The most dangerous complication of endometrial hyperplasia is its transformation into uterine cancer. However, bleeding and relapses with the development of infertility and anemia are no less dangerous.
In most cases, the prognosis is favorable: as a result of surgery and taking drugs for 6-12 months, it is possible to completely cure the disease.
Prevention
The most important measures for the prevention of endometrial hyperplasia are the prevention of stressful situations, the active fight against excess weight and the immediate treatment of menstrual cycle disorders. In addition, timely gynecological examination of women is very important.
Sometimes for young girls, a specialist may recommend hormonal drugs for prevention, which help reduce the risk of endometrial hyperplasia and cancer. Any woman should be aware that if uterine bleeding occurs, you should immediately contact a specialist. Remember that seeing your doctor early can help you avoid most problems in the future.
