Systematic histological studies of the endometrium and the ovary were carried out on 253 uteri removed from the women who had been mpre than one year after menopause, and the following results were obtained.1) The endometrium after menopause was classified into the atrophic type (74.7%), early proliferative type (10.7%) and hyperplastic type (14.6%), and the histological pictures of each type were described in detail.2) The distribution of the Types in the endometrium of the uteri with myoma or cancer of the cervix was not different significantly from that in the normal post-menopause endometrium shown above. In the endometrium of adenomyosis, the early proliferative type was more frequently observed than in the control, but the hyperplastic type was not encountered. The endometrium of the patients with hepatic diseases and that around the cancer of the uterine body showed either the early proliferative or the hyperplastic type more frequenty than the control endometrium. The difference was statistically significant. All of the four mammary cancer cases had the atrophic type of the endometrium.3) There was no difference in the occurrence rate of ovarian stroma hyperplasia between the ovaries of the cases with uterine myoma or cancer of the cervix and the ovaries of the control. It was slightly more frequently observed in the cases with uterine adenomyosis, less in the cases with hepatic diseases, and significantly more in those with cancer of the uterine body, compared with the control ovaries. Ovarian stroma hyperplasia was not found in the cases with mammary cancer.4) The proliferation of the cells in the follicular wall seemed to take part in the proliferation of the endometrium even after menopause. It was found that the ovarian stroma hyperplasia acted as a stimulation on the proliferation of the endometrium. The proliferation of the endometrium after menopause was supposed to be stimulated also with adreno-cortical hyperfunction, the decreased estrogen-inactivating action in hepatic disturbances, increased sensitivity of the local endometrium to estrogen, and the disappearance of antagonizing hormones.5) Endometric polyps or growths after menopause were observed in 26.1% of the all cases. The size, location and histological components of the endometric growths and histological pictures of the surrounding endometrium and the ovaries were investigated.6) The findings on 17 cases of endometrium after menopause with fluorescence microscope were compared with the morphological pictures. There seemed no distinctive parallel relation between the two. However, fluorescence in the atrophic type, as a rule, was strong than fluorescence in the endometrium with hyperplastic stimulation of sex-hormones. So fluorescence in the post-menopause endometrium tended to be strengthened with hyperplastic stimulation of sex-hormones.7) The age, histories in menstruation and birth, clinical symptoms, chief complaint and complications of the cases with extremely proliferated post-menopause endometrium were investigated and compared with those of the cases with cancer of the uterine body.
Read full abstract