A Study to Correlate Endometrial Hyperplasia with Ovarian Stromal Change

Background: Endometrial hyperplasia in peri-menopausal age group is frequently encountered as a result of unopposed excess estrogen action, exact source of which is still debatable. Possible source is ovarian stroma. There must be some subtle changes in ovarian stroma to produce excess estrogen in such states. This study was performed to provide new insights into the various patterns of subtle ovarian stromal changes and its relation to morphological alteration of endometrial glands and stroma. Methods: 62 women in peri-menopausal age group, diagnosed as endometrial hyperplasia on uterine curettage and unresponsive to conventional therapy, treated by total hysterectomy with unilateral/bilateral salpingo-oophorectomy, were chosen randomly. Serial step sections of endometrial biopsies were examined by routine microscopy. Endometrial hyperplasia was classified following the current WHO classification. The sections from the ovary were examined for changes in the ovarian stroma. Results: Out of the 62 total cases having endometrial hyperplasia, 53 cases (83.5%) had one or more subtle ovarian stromal changes and 9 cases (14.5%) lacked the ovarian stromal changes. Out of the 50 cases without endometrial hyperplasia, only eight had subtle ovarian changes. In the 53 cases, which showed ovarian stromal changes, the changes were found in combination and variable proportions. Conclusion: Ovarian stromal changes were significantly associated with endometrial hyperplasia.