What are the other Names for this Condition? (Also known as/Synonyms)
- Endometrial Glandular Metaplasia, Hobnail Type
- Hobnail Type of Uterine Metaplasia
- Metaplasia of Uterine Corpus, Hobnail Type
What is Hobnail Metaplasia in Endometrium? (Definition/Background Information)
- Metaplasia in endometrium is a common benign condition that occurs in the glands of the endometrial lining (of the uterus). Metaplasia is defined as a change of one cell type to another cell type
- Hobnail Metaplasia in Endometrium is a type of metaplasia noted in the uterine corpus. It is diagnosed by a pathologist on examination of endometrial tissue under a microscope
- It is also known as Hobnail Clear-Cell Metaplasia in Endometrium. The significance of the findings is that the metaplasia may present an indirect evidence of the presence of a causative factor (that may require treatment)
- Hobnail Metaplasia in Endometrium is observed to form secondary to various conditions affecting the uterus, which includes endometrial hyperplasia, endometrial cancer, and inflammation of the uterine lining
- Typically, there are no signs and symptoms or complications directly associated with Hobnail Metaplasia in Endometrium. However, the underlying cause of the condition may present significant signs and symptoms or complications
- A treatment may be undertaken for the underlying cause of Hobnail Metaplasia in Endometrium, as required. The prognosis is related to the underlying cause and its treatment
Who gets Hobnail Metaplasia in Endometrium? (Age and Sex Distribution)
- Hobnail Metaplasia in Endometrium is a condition affecting women of a wide age range
- No racial or ethnic group predilection is observed
What are the Risk Factors for Hobnail Metaplasia in Endometrium? (Predisposing Factors)
The risk factors for Hobnail Metaplasia in Endometrium may include the following conditions:
- Puberty causing hormonal imbalance is thought to induce transformation (metaplasia)
- Any condition resulting in an abnormal endometrium including hyperplasia
- Endometritis: Inflammation of the endometrial lining
- Menstruation, where periodic shedding of the endometrium takes place
- Atypical hyperplasia: Abnormally increased growth of endometrial glands observed with cell changes
- Endometrial carcinoma
- Polycystic ovarian syndrome (PCOS)
- Bacterial infections such as tuberculosis
- Chemical irritants causing allergic reaction
- Foreign body such as intrauterine contraceptive device (IUCD)
- Chronic trauma
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Hobnail Metaplasia in Endometrium? (Etiology)
The exact cause of Hobnail Metaplasia in Endometrium is unknown. However, it is known to occur in the following situations:
- Any condition that causes a breakdown of the endometrium
- Hormonal imbalance in the body
- Conditions causing chronic endometrial inflammation
In some cases, metaplasia in endometrium may be a physiological condition.
What are the Signs and Symptoms of Hobnail Metaplasia in Endometrium?
- Generally, there are no significant signs and symptoms directly associated with Hobnail Metaplasia in Endometrium
- The signs and symptoms of the underlying condition causing metaplasia may be observed and this may vary from one individual to another
How is Hobnail Metaplasia in Endometrium Diagnosed?
Hobnail Metaplasia in Endometrium is diagnosed by a pathologist on examination of endometrial tissue under a microscope. This is established through the following procedures:
- An endometrial tissue biopsy is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
- Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
- Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis
Note:
- The endometrial tissue could be examined as part of an endometrial curetting or endometrial biopsy; sometimes, a hysterectomy specimen may be examined
- On examination of the endometrial tissue under the microscope by a pathologist, one metaplasia type may be mixed with other metaplasia types
Once a diagnosis of Endometrial Glandular Metaplasia (Hobnail Type) is established, the healthcare provider may perform the following tests and procedures to determine the underlying cause or rule out any associated conditions:
- A detailed medical history evaluation followed by a physical and pelvic exam
- Ultrasound scan of the pelvis: It is a noninvasive procedure that uses high frequency sound waves to produce real-time images
- Abdominal and pelvic CT scan: It is a noninvasive procedure that provides more details of soft tissues, blood vessels, and internal organs
- Pelvic MRI scan: It is a noninvasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal structures of the abdomen and pelvis
- Hysteroscopy: This procedure involves placing a probe through the cervix to examine the cavity of the uterus
- Hysterosalpingography: It is usually performed in individuals with infertility. In this procedure, the structure of the uterus and fallopian tubes are studied by using a dye and X-ray images
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Hobnail Metaplasia in Endometrium?
- Generally, there are no complications associated with Hobnail Metaplasia in Endometrium
- Nevertheless, complications associated with the underlying condition may be noted
How is Hobnail Metaplasia in Endometrium Treated?
- Hobnail Metaplasia in Endometrium is caused by various conditions. The treatment depends upon the underlying cause of the metaplasia
- In many cases, the treatment involves hormonal manipulation (restoring any hormonal imbalance in the body)
- No specific treatment may be necessary for some forms of metaplasias, unless abnormalities are noted
- Also, if the underlying cause is not associated with any signs and symptoms, then treatment may not be required
How can Hobnail Metaplasia in Endometrium be Prevented?
- Currently, there are no definitive methods available to prevent Hobnail Metaplasia in Endometrium
- Medical screening at regular intervals with scans and physical examinations are advised
What is the Prognosis of Hobnail Metaplasia in Endometrium? (Outcomes/Resolutions)
- Hobnail Metaplasia in Endometrium by itself does not indicate a medical condition or an abnormality. However, the reason for metaplasia may be of clinical significance and may need to be investigated and addressed further. Hence, the prognosis is directly associated with the prognosis of the underlying cause and its suitable treatment
- If the metaplastic changes are associated with atypical features and if such changes are persistent on repeated endometrial biopsies, a careful workup to determine the underlying cause should be performed
- It is important to note that atypical changes in metaplasia in endometrium do not always indicate an association with malignancy, since such atypical changes can be caused by benign conditions too
Additional and Relevant Useful Information for Hobnail Metaplasia in Endometrium:
- Endometrial cancer is a type of cancer that begins in the lining of the uterus (the endometrium). The majority of endometrial cancer cases are detected and diagnosed in women aged 50 years and older
The following link may be a useful resource for endometrial cancer:
http://www.dovemed.com/diseases-conditions/endometrial-cancer/
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