FIGURES AND TABLES

FIGURE 1.

High-potency progesterone oral contraceptive (used for endometrial hyperplasia) effect: small inactive glands, hyperplastic stroma, and thickened blood vessels.

FIGURE 2.

Commonly used oral contraceptive effect: atrophic endometrial epithelium, stromal decidual reaction, and thin dilated blood vessels.

FIGURE 3.

Ovulation induction therapy: endometrial glands with early secretory changes with subnuclear vacuoles, consistent with days 16 to 17, and stroma with edema and spiral arterioles, consistent with days 22 to 23.

FIGURE 4.

Ovulation induction therapy for polycystic ovarian disease with endometrial complex atypical hyperplasia and infertility. The patient conceived and had a spontaneous abortion. Endometrial curettings showed chorionic villi (left lower corner) and focal well-differentiated adenocarcinoma.

FIGURE 5.

Hormone replacement therapy: 56-year-old postmenopausal woman treated for 4 years with estrogen alone. Endometrial complex glandular hyperplasia with squamoid morules.

FIGURE 6.

Same patient as Figure 5 after 6 months of combined estrogen-progesterone therapy. The glands appear quiescent and focally secretory; squamoid morules persist.

FIGURE 7.

Hormone replacement therapy of postmenopausal 59-year-old woman with combined estrogen/progesterone (Prempro). Mixed endometrium: secretory endometrium with focally hyperplastic glands.

FIGURE 8.

Hormone replacement therapy for 10 years with estrogen and cyclic progesterone added for 10 days a month in a 71-year-old patient: well-differentiated adenocarcinoma.

FIGURE 9.

Progesterone therapy for endometrial neoplasm: 32-year-old patient with endometrial carcinoma, after 6 months of therapy with medroxyprogesterone acetate 40 mg daily. Endometrial biopsy shows back-to-back crowded glands with intraluminal secretion.

FIGURE 10.

Same patient as in Figure 9, after 6 months more on high-potency progesterone (Megace). Endometrial biopsy shows cribriform pattern with secretory changes. Subsequent hysterectomy revealed an endometrial carcinoma invading 70% of myometrial thickness.

FIGURE 11.

Tamoxifen therapy for breast cancer in a 76-year-old patient. Uterus weighed 1280 g, showing diffuse adenomyosis, myohyperplasia, endometrial polyps, and atypical glandular hyperplasia.

FIGURE 12.

Tamoxifen therapy for breast cancer for 5 years. Endometrial biopsy with mucinous and squamous metaplasia, imitating endocervical tissue.

FIGURE 13.

Tamoxifen therapy for breast cancer for 8 years and medroxyprogesterone acetate therapy added for the past 2 years. Endometrial adenocarcinoma with irregular glandular secretory changes.

FIGURE 14.

Tamoxifen therapy for breast cancer for 10 years and progesterone therapy (Megace) added for the past 4 years. Endometrial adenocarcinoma with secretory vacuoles seen on biopsy. The tumor invaded 70% of the myometrial thickness at subsequent hysterectomy.

TABLE 1 - Luteal Phase Defect.

TABLE 2 - Endometrial Histology in Oral Contraceptive Therapy.

TABLE 3 - Hormone Replacement Therapy.