Extreme cystic endometrial hyperplasia
Keywords: feline, uterus, CEH, hyperplasia
The uterus of an adult domestic long haired cat.
Image size: 1000 x 1333px. Author and owner of copyright: Dr Stephanie N. Simpson (stephanienicolesimpson@gmail.com)
The cat was presented in good health with a mildly distended abdomen. When its uterus was exteriorized, this appeared to be a case of pyometra. However after hysterectomy and upon opening the uterus, no pus was present. Instead, the enlargement of the uterus had been caused by the remarkably distended cystic structures shown here. Because of financial constraints, the histology of the uterus was not examined. In the absence of histopathology, this was presumed to be an extreme expression of cystic endometrial hyperplasia (CEH).
The case is remarkable because of the dramatic nature of the CEH.
CEH in cats has been eloquently examined, summarized and referenced by Dr Robert Foster (rfoster@uoguelph.ca) and readers are encouraged to visit his site for more information.
Essentially, CEH is associated with age and occurs in approximately 20 to 40% of cats where no clinical signs are present. The endocrinology of CEH has been investigated and is thought to be linked to a higher-than-normal expression of estrogen receptors in the endometrium. It frequently occurs in a luteal phase but as for pyometra in this species, not all cases occur after ovulation. In dogs by contrast, elevated progesterone, CEH and pyometra are virtually inseparable.
