Respond to the following discussion post by discussing the condition while encompassing your clinical experiences and critique the post. Citations: At least one high-level scholarly reference in APA per post from within the last 5 years. (Don’t worry about my clinical experience- I can add my clinical experience in after).
Diagnosis
An endometrial biopsy has been completed for a 40-year-old female. The final report gives a diagnosis of benign endometrial hyperplasia. This medical disorder affects the female reproductive system and displays in the patient with hyperplastic changes in the endometrial glandular and stromal structures that line the uterine wall (Sobczuk & Sobczuk, 2020). It is found to be the outcome of too much estrogen and too little progesterone within the patient’s hormone levels. The condition causes the uterine lining to thicken more than normal levels due to having more cells than typically found in a patient without this condition. This is because the lack of progesterone found within the patient’s body causes the uterus to not completely shed the endometrial lining. Due to the abnormal thickening of the uterine lining, the patient can experience abnormal endometrial uterine bleeding. While the word benign does mean the condition is non-cancerous, any patient diagnosed with this condition will have an increased risk of endometrial cancer. Accurate identification of precancerous lesions of the endometrium and elimination of coexisting endometrial carcinomas are required for the ideal management of patients (Sobczuk & Sobczuk, 2020).
Cell Type and Atrophy vs Hyperplasia
The endometrium made up of a grouping of single-layered prismatic epithelium with or without cilia and its basal lamina, uterine glands, and a cell-rich connective tissue (which is called stroma) that is rich with a supply of blood vessels. The cells that are affected endometrial hyperplasia are epithelial cells. The cells then create epithelial tissue, and that lines the interior areas of the body, including the uterus (Dlugash & Story, 2021, P. 340).
Atrophy happens in this situation when the cell workload has decreased and that results in a decrease in the dimension and the number of cells. There are many ways that atrophy can occur: ischemia, nutritional imbalances, a decrease in endocrine function, and lack of use (Dlugash & Story, 2021).
With the issue of endometrial hyperplasia, an abnormal stimulation of estrogen occurs (Dlugash & Story, 2021). This can be the consequence of either normal or abnormal stimuli. With hyperplasia, as opposed to atrophy, the cells increase in their numbers. This increase can only happen in cells that are able to perform mitotic division, which epithelial cells are able to do. Atypical hyperplasia has changes in gland cells. Complex hyperplasia has an increase in the gland to stroma ratio with glandular crowding (Gunjan Singh; Yana Puckett., 2020).
Dysplasia different from Hyperplasia
One of the ways that dysplasia and hyperplasia differ from one another is their appearances under a microscope. While hyperplasia will be visualized as having a normal appearance, there will be an abundance of them. However, dysplasia will have cells that are visualized as abnormal (Nci Dictionary of Cancer Terms, n.d.). Dysplasia is a result of cells that have changed or mutated their size, shape, and appearance. When this mutation occurs within the cells, it is typically thought to prelude cancerous cells. Although dysplasia is abnormal, it is potentially reversible by removing the trigger (Dlugash & Story, 2021).
Hyperplasia Leading to Neoplasia
Although pathological hyperplasia may sometimes progress into neoplasia, hyperplasia itself does not always lead to neoplasia, (David R. H, Sylvia L. ASA, 2009). Hyperplasia can also at times be mistaken as benign neoplasia, due to the gross enlargement of tissues and organs (Gunjan Singh; Yana Puckett., 2020). Once the divided cell takes over the normal tissues and transitions away from the origin site, hyperplasia develops into neoplasia. Hyperplasia is known to be the result of a rise in stimuli and the sutruce of the cells remaining normal. Neoplasia is the result of repeated environmental exposure or due to epigenetic factors.
References
David R. H, Sylvia L. ASA. (2009). Hyperplasia – an overview | sciencedirect topics. www. sciencedirect.com. https://www.sciencedirect.com/topics/nursing-and-healthprofessions/hyperplasia
Dlugasch, L., & Story, L. (2021). Applied pathophysiology for the advanced practice nurse (1st ed.). Burlington, MA: Jones and Barlett Learning.
Gunjan Singh; Yana Puckett. (2020, November 17). Endometrial hyperplasia – statpearls – ncbi bookshelf. www.ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK560693/
Nci dictionary of cancer terms. (n.d.). National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hyperplasia
Sobczuk, K., & Sobczuk, A. (2017). New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Przeglad Menopauzalny, 16(3), 107- 111. http://dx.doi.org/10.5114/pm.2017.70589