The risk of endometrial cancer is highest with the following histological pattern of endometrial hyperplasia

Ans. is d i.e. Complex hyperplasia with atypia Friends, let's first try to figure out this question on the basis of our basic knowledge of neoplasia. We all have read time and again that in 'Neoplasia' atypical cells are present, therefore obviously out of the given options, either option "b"or -d"is correct and since neoplasia is most likely to occur in complex situations therefore out of the given options even if I don't know anything about Endometrial hyperplasia I would have gone for option "d". Let's now have a look at Endometrial hyperplasia. Endometrial Hyperplasia It represents a spectrum of morphological and biological alteration of endometrium (both glandsdeg +Stromadeg), ranging from an exaggerated physiological state to carcinoma in situ. They are clinically impoant because : They cause abnormal bleeding.deg Either preceede or occur simultaneously with Endometrial carcinoma. Endometrial Hyperplasia can be : If atypical cells are present in either of the two types - chances of malignancy increase. Simple atypical hyperplasia is a relatively uncommon diagnosis. In general, most atypical hyperplasias have a complex architecture. Characteristics of Atypical cells :deg You must have already learnt in pathology, but I will brief it up here for convenience : Large in sizedeg Loss of polaritydeg Irregular shapedeg Hyperchromatic nucleusdeg and prominent nucleolideg Altered nucleus/cytoplasmic ratio.deg Chances of Progression to Carcinoma : Type of hyperplasia Simple without atypia Complex without atypia Simple with atypia Complex with atypia Thus, minimum chances of progression to carcinoma are with simple-hyperplasia without atypia and maximum chances of carcinoma are with complex hyperplasia with atypia.deg