Question

Ms. Jones has a gynecologic exam and an annual Pap smear. Three years ago, immediately before her third pregnancy, the pathology report of her Pap smear indicated she had hormonal hyperplasia. Her current Pap smear indicates she has atypical hyperplasia, or dysplasia. Based on your knowledge of cellular adaptation discuss the difference between hormonal hyperplasia and atypical hyperplasia that is seen in this patient.

Answer 1

Hormonal hyperplasia is normal and is caused by the influence of hormones it only affects organs that are affected by hormones, such as the uterus. It has a specific function.

Atypical hyperplasia is not normal, it is an increase in cell division, which can lead to cancer, the body does not need it but something altered the mechanism of cell division and their check points.

Step-by-step explanation:

There are different types of cellular adaptation, hyperplasia is one of them, and is an increase in cell division. Hyperplasia is the increase in cell division in tissues that are under the influence of hormones, mostly estrogen. In the case of Ms. Jones, her uterus' cells experienced hormonal hyperplasia when she got pregnant, in other words, the number of cells increased to allow the development of the baby. Three years later, her Pap smear showed that she had atypical hyperplasia, which means that there is an increase in the number of cells, in this case in her cervix. This is not normal and can lead to cancer.

Answer 2

Atypical hyperplasia is suggestive condition of squamous intraepithelial neoplasia while endometrial hyperplasia represent a fisiologic adaptation; while endometrial hyperplasia represents a physiological change secondary to the influence of estrogens observed in conditions such as pregnancy.

Step-by-step explanation:

Endometrial hyperplasia (tissue present in the uterus) is an entity in which there is a proliferation of endometrial glands in its size whit an irregular shape, and a greater proportion of glands on the stroma, as a direct consequence of excessive exposure to estrogen. Estrogen are hormones that are responsible for stimulating glandular proliferation in this particular tissue an increase of estrogens usually occurs in pregnancy.

In contrast, in atypical hyperplasia in cervix cells present morphological alterations within a carcinogenesis process, suggestive of the existence of a category called squamous intraepithelial lesion. This could be suggestive of cervical cancer. In the category of atypia, the cells present nuclear and/ or cytoplasmic alterations that exceed the cellular reactive changes to the reparative ones are included, but that even for their quantity and quality are not sufficient for a definitive diagnosis of squamous intraepithelial lesion.