Endometrial polyp

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Endometrial polyps are benign overgrowths which project above the surface of the endometrium. The disease has been associated with estrogen and Tamoxifen, which may indicate hormone-dependent growth.

Endometrial polyps occur commonly (25% incidence), and are most common in women over 40 years old. Usually, the condition is asymptomatic, though it can manifest as abnormal genital tract bleeding in the form of spotting or menometorrhagia. Patients could also present with infertility.

Upon gross pathological inspection, most endometrial polyps are 0.5-3.0cm in size, though they can be large enough to fill the entire endometrial cavity and extend into the cervical canal. There may be either single (80%) or multiple (20%) polyps, and they may be pedunculated or sessile.

Microscopically, the polyps consist of three components: Endometrial glands; a fibrous stroma; and thick-walled blood vessels. There are two types of endometrial polyps: those that resemble functional cycling or non-cycling endometrium; and those that appear hyperplastic, and are associated with endometrial hyperplasia. Rarely, there is a malignancy present.

Diagnosis can sometimes be difficult, as the polyp may elude sampling, or may become fragmented with sampling and not be recognized on biopsy. Usually, diagnosis is made with an endometrial biopsy or polyp resection.