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  • Title: Ultrastructural effects of estrogen replacement on postmenopausal endometrium.
    Author: Aycock NR, Jollie WP.
    Journal: Am J Obstet Gynecol; 1979 Oct 15; 135(4):461-6. PubMed ID: 573552.
    Abstract:
    Endometrial adenocarcinoma occurs almost exclusively in postmenopausal women, and excessive or unopposed estrogen stimulation is suspect as a causative factor in its pathogenesis. Furthermore, the incidence of endometrial adenocarcinoma has increased in women undergoing estrogen replacement therapy. In the present study, the cellular response of premenopausal and postmenopausal endometrium to estrogenic stimulation was compared with endometrial adenocarcinoma by the electron microscope. Tissues were obtained at hysterectomy, endometrial biopsy, or endometrial curettage and were processed routinely for light and electron microscopy. Ultrastructurally the endometrium from postmenopausal patients undergoing estrogen replacement therapy was similar to normal cyclic endometrium in the late proliferative phase. At least three features of the estrogen-treated postmenopausal tissue resembled those observed in adenocarcinoma of the endometrium: accumulation of lipid droplets, irregular nuclei, and perinuclear whorls of microfibrils. Specimens from 5 postmenopausal endometria were obtained from patients undergoing estrogen replacement therapy (ERT) and were examined by electron microscope in an effort to characterize the cellular response of postmenopausal tissue to estrogenic stimulation. In addition, the ultrastructure of endometrium from patients undergoing ERT was compared with that of adenocarcinoma of the endometrium. The results are presented in 5 electron micrographs. Tissue specimens from ERT patients exhibited adenomatous hyperplasia: accumulation of lipid droplets, irregular nuclei, and perinuclear bundles of microfibrils (n=3 specimens). Ultrastructurally, the endometrium from postmenopausal patients undergoing ERT was similar to normal cyclic endometrium in the late proliferative phase.
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