RESUMO
The aim of this investigation is to study the histological difference in the endometrial glands in the basal plate and during endometrial hyperactivity and consequently the probable cause of endometrial bleeding associated with endometrial hyperactivity. Basal plate specimens were obtained after informed consent form 4 patients undergoing caesarean section at full term. Endometrial hyperactivity specimens were obtained after informed consent form 4 patients aged 40-50 years complained of uterine bleeding. The specimens obtained by curette biopsies. The specimens from the basal and hyperactive endometrium were carefully dissected and processed for light and electron microscope examination. Light microscopic examination of the basal endometrium sections revealed that; the endometrium was thin with decreased endometrial tissues, the endometrial glands were few, dilated and adjacent to the myometrial muscle layer. They were lined by single layer of cuboidal epithelium resting on a basement membrane with deeply stained nuclei and basophilic cytoplasm. The stroma in between the glands contains few cells with deeply stained nuclei. Electron microscope examination of the basal endometrium revealed that; the endometrial glands were lined by cuboidal epithelium resting on a clear basement membrane with central rounded nuclei, lipid droplets and scattered mitochondria. Their apical surface showed short microvilli. The stromal cells of the endometrium appeared with heterochromatic nuclei. Light microscopic examination of the sections of the hyperactive endometrium revealed thick endometrium with abundance of endometrial tissues with many normal and enlarged glands of different sizes and shapes. The glands were lined by several layers of slightly enlarged tall columnar cells, with oval deeply stained basophilic nuclei. Electron microscope examination of hypcractive endometrium revealed the endometrial glands were lined with one or two layers of simple columnar epithelium with basal oval or rounded nuclei. The epithelium contained two types of cells: light and dark cells with many mitochondria of different shapes. Also junctional complexes were noticed between the lateral borders of columnar cells. They were rested on a clear basement membrane. The columnar cells were appeared with long and dense apical microvilli and occasionally cilia. The stromal cells appeared with euchromatic nuclei and some leucocytes were also noticed. The endometrial structure differs greatly from the basal plate to hyperactive state. These results assist the pathologists to differentiate between endometrial hyperactivity and atypical endometrial hyperplasia which may be a pre malignant condition