Severe atypical hyperplasia

Atypical hyperplasia can cause nodules or cysts to appear at the site of hyperplasia. In severe cases, it can lead to cancer in patients. I hope everyone can pay attention to the problem of atypical hyperplasia. When atypical proliferation of epithelial cells occurs, the nodules need to be removed promptly, and postoperative care should be provided. However, breast hyperplasia can cause abnormal breast milk secretion and requires timely treatment.

About severe atypical hyperplasia

As far as breast hyperplasia is concerned, the incidence rate among women over 25 years old accounts for more than half of the percentage. This more or less gives us female friends a warning about our physical health.

Atypical hyperplasia often occurs in squamous epithelium, but can also occur in glandular epithelium. Atypical squamous epithelial hyperplasia can be divided into three grades: mild, moderate, and severe according to the degree of atypia and/or the scope of involvement. If this change involves 1/3 of the lower part of the epithelium, it is mild atypical hyperplasia; if it involves more than 1/3-2/3 of the lower part of the epithelium, it is severe atypical hyperplasia; if it involves the entire layer of the epithelium, it has become carcinoma in situ. Mild to moderate atypical hyperplasia can return to normal after the cause is eliminated. Severe atypical hyperplasia is difficult to reverse and often turns into cancer. Intraepithelial neoplasia includes atypical hyperplasia and carcinoma in situ. Mild, moderate and severe atypical hyperplasia are called intraepithelial neoplasia grade I, II and III respectively, and carcinoma in situ is also included in intraepithelial neoplasia grade III. The above-mentioned precancerous diseases and lesions often become cancerous through atypical hyperplasia. Lobular hyperplasia of the breast can be divided into three categories according to the degree of epithelial hyperplasia: mild, severe and atypical hyperplasia. Simple lobular hyperplasia generally does not lead to cancer, but high-grade hyperplasia and atypical hyperplasia may lead to cancer and are also one of the risk factors for breast cancer. 95% of the lobular hyperplasia diagnosed clinically is simple lobular hyperplasia, which is not closely related to breast cancer. Therefore, the vast majority of lobular hyperplasia is not a precancerous lesion, but atypical hyperplasia is closely related to breast cancer.

What is mild atypical hyperplasia?

Atypical hyperplasia: refers to the fact that the morphology of the epithelial cells shows a certain degree of atypicality, but it is not enough to be diagnosed as cancer. Microscopically, the proliferating cells are of different sizes and shapes, with large and darkly stained nuclei, an increased nuclear-cytoplasmic ratio, and increased nuclear divisions, but most of them are normal. The cells are arranged in a disordered manner and the polarity disappears.

Atypical hyperplasia usually has no obvious symptoms. If obvious symptoms appear, it is possible that the lesion has progressed to cancer. The following are some common manifestations:

(1) Leukoplakia. It often occurs in the mucous membranes of the oral cavity, esophagus, vulva, etc. The lesions appear as white patches to the naked eye, and under the microscope, the squamous epithelium is hyperproliferated and keratinized with a certain degree of atypia. The lesions may develop into squamous cell carcinoma.

(2) Cervical erosion. It refers to the replacement of the squamous epithelium of the cervical vagina by columnar epithelium from the endocervical canal. During the healing of erosions, reserve cells proliferate and metaplasia into squamous epithelium. Chronic inflammatory processes can lead to incomplete squamous cell carcinoma and dysplasia, a small number of which may develop into cervical squamous cell carcinoma.

(3) Fibrocystic breast disease. It mainly features proliferation and cystic changes of mammary lobular duct and alveolar epithelial cells, among which those accompanied by intraductal papillary hyperplasia are more likely to develop cancer.

(4) Multiple polyposis of the colon. There is often a family history, which can lead to adenocarcinoma.

(5) Chronic atrophic gastritis. Intestinal metaplasia can occur in the gastric mucosal glands, which has a certain relationship with the occurrence of gastric cancer.

Treatment of atypical hyperplasia

Treatment of atypical hyperplasia depends on the extent of the disease. For mild lesions, treatment is generally not required, but regular follow-up should be performed. However, for moderate and severe lesions, since they are difficult to clear by themselves, appropriate treatment is required. Clinically, methods for treating moderate and severe lesions are generally divided into two categories: physical therapy and surgical resection.

Physical therapy: This includes laser therapy and cryotherapy, which destroys abnormal tissue by heating or freezing it.

Surgical resection: Abnormal tissue is removed surgically. The removed tissue can also be used for pathology to make a tissue diagnosis (hence it is also called a biopsy).

In general, mild atypical hyperplasia does not require treatment. Although some mild atypical hyperplasia does not require treatment, we still need to pay enough attention to it. Do not drink alcohol, do not eat spicy foods, and consume more foods such as vitamins. Mild to moderate atypical hyperplasia can return to normal after the cause is eliminated.