follicular gland cell proliferative syndrome
Introduction
Introduction to follicular gland cell proliferation syndrome Follicular gland cell proliferation syndrome refers to a group of syndromes in which a series of symptoms and signs such as female masculinity appear in the clinic, and pathological changes of ovarian membrane proliferation. Intrinsic as described by Culiner and Shippel in 1949, indicating that there are luteinized vesicle cells in the stroma, but not related to adjacent follicles. It was later found to be often accompanied by masculinity. These diseases were originally included in the "polycystic ovary syndrome", but in recent years, due to the progress of steroid determination methods and the clinical application of clomiphene, the diagnosis of the intrinsic is very helpful, because of the use of clomiphene In the case of "polycystic ovary syndrome", it can cause ovulation (ovulation rate of 75%), but it is ineffective. Therefore, it is necessary to distinguish the intrinsic from "polycystic ovary syndrome". basic knowledge The proportion of illness: 0.001% Susceptible people: women Mode of infection: non-infectious Complications: Acne
Cause
The cause of follicular gland cell proliferation syndrome
(1) Causes of the disease
The intrinsic etiology is unknown, because intrinsic in some aspects have something in common with "polycystic ovary syndrome", such as rare menstruation, amenorrhea, hairy, obesity and ovarian enlargement, so in the past people talked about the two The increase in testosterone in patients with follicular gland cell proliferation syndrome may be related to the lack of certain enzymes in the ovary, and lead to estrogen production disorders, and also cause hypothalamic-pituitary dysfunction, which seems to be associated with polycystic ovary syndrome. Similar, but from the pathological and clinical manifestations, the intrinsic ovary does not have a thickened fibrotic envelope, and there is a layer of surrounding follicular cells proliferating in the ovarian cortical stroma. The follicles are mostly primordial follicles and masculine The clinical manifestations of the disease, so the pathogenesis of the intrinsic remains to be further explored in the future.
(two) pathogenesis
1. The general view of the ovary often increases bilaterally, the maximum diameter can reach 7cm, the surface of the ovary is smooth, the milky white is shiny, the small cyst in the cortex protrudes to the surface, and the surface can also see a lot of scattered small yellow areas, multiple The small capsule is filled with clear liquid.
2. Microscopic examination of the surface of the ovary is interstitial collagen, there are many original follicles, and there are early growth follicles, there are many cystic follicles of different sizes in the deep, and there is a layer of luteinized hyperplasia Follicular cells, no corpus luteum, distant from the cystic follicles, there are many small nests of polygonal interstitial follicular cells, which contain lipidoids.
Prevention
Prevention of follicular gland cell proliferation syndrome
Early detection, timely treatment, and good follow-up. Regulate dietary structure, low-fat, low-sugar and low-calorie diet, optimize diet and balance nutrients. Keep a good mood, depressed, angry and fearful emotions will stimulate the fragile nerves, destroy the regulation of endocrine, and reduce the body's immunity. Improve the intensity of exercise, suitable for exercise to promote blood circulation of the human body, improve the body's ability to resist, and benefit endocrine coordination.
Complication
Complications of follicular gland cell proliferation syndrome Complications
The increase of testosterone in patients with follicular gland cell proliferation syndrome may be related to the lack of certain enzymes in the ovary, causing estrogen production disorders, increased testosterone, and causing hypothalamic-pituitary dysfunction. Often accompanied by masculinity. Female sexual decline such as breast atrophy, shoulder and buttocks disappeared, menstruation decreased or disappeared. Male characteristics such as beard and pubic hair are male-like distribution, muscle development, face and chest acne, and enlarged larynx.
Symptom
Symptoms of follicular gland cell proliferation syndrome Common symptoms Menstrual rare masculine amenorrhea
1. Menstrual changes, most of the obese intrinsic patients showed rare menstruation at the beginning, which can eventually lead to amenorrhea and obvious obesity.
2. The masculinity sign is in the cheeks of the intrinsic person. The mandible and neck are hairy, and the raw hair, the larynx is enlarged, the breast atrophy is different, and the clitoris is hypertrophied.
3. The gynecological examination showed that the patient's vaginal wall was smooth, atrophy, cervical atrophy, uterus was found during laparotomy, the fallopian tube was normal, and the bilateral ovaries were enlarged.
Examine
Examination of follicular gland cell proliferation syndrome
1. Blood routine, serum electrolytes, blood urea nitrogen and creatinine in the normal range.
2. Testosterone is elevated in patients with hairy testosterone levels higher than the average of normal women, but one third of the intrinsic patients can be within the normal range.
3. The dexamethasone suppression test was normal, and there was a significant increase after the use of chorionic gonadotropin.
4. The patient's urine 17-hydroxyl, 17-ketone are normal.
5. The oral glucose tolerance test was significantly abnormal.
Histopathological examination.
Diagnosis
Diagnosis and differentiation of follicular gland cell proliferation syndrome
diagnosis
Histologically, in the ovarian stroma that is far from the follicle, when there are cells that are morphologically similar to the vesicular cells and contain fat, it can be diagnosed as follicular gland cell proliferation syndrome. When these pathological phenomena are accompanied by clinical masculinization, The diagnosis is follicular gland cell proliferation syndrome, and the clinical manifestations are similar to those of polycystic ovary syndrome, which are easily confused.
Differential diagnosis
Different from polycystic ovary syndrome.
