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Contents: Pathology Outlines – Dating of endometrium My approach to the interpretation of endometrial biopsies and curettings Clinical history. In complex hyperplasia, there is an increase in the gland to stroma ratio with glandular crowding. The glands are often closely packed, although some stroma usually remains between individual glands. The glands show proliferative activity and, by definition, there is no nuclear atypia. Simple hyperplasia is usually a generalised condition, whereas most, but not all, cases of complex hyperplasia are focal, often occurring on a background of simple hyperplasia. In atypical hyperplasia, there is, by definition, nuclear atypia. In atypical hyperplasia, the nuclear changes are often accompanied by cytoplasmic changes, such that the cells have more abundant, often eosinophilic, cytoplasm. Cytoplasmic changes, including increased cytoplasmic eosinophilia, may also be seen in various endometrial metaplasias, such as ciliated metaplasia. Nuclear features in atypical hyperplasia, which, as stated earlier, are often subtle, include nuclear stratification, loss of polarity, nuclear rounding and the presence of nucleoli. In fact, rather than overt nuclear atypia, it is often the differing nuclear features between abnormal and normal glands that is characteristic.

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It is surrounded by five landlocked countries: Kazakhstan to the north ; Kyrgyzstan to the northeast ; Tajikistan to the southeast ; Afghanistan to the south and Turkmenistan to the south-west. Along with Liechtenstein , it is one of two doubly landlocked countries. As a sovereign state , Uzbekistan is a secular , unitary constitutional republic.

It comprises 12 provinces vilayats and one autonomous republic, Karakalpakstan.

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