Histology of Uterus-Proliferative Phase or Follicular Phase

Proliferative Phase
Histology. Estrogenic stimulation causes the endometrium
to regenerate and proliferate. In the early proliferative phase
the glands are straight and narrow and the glandular epithelium
is cubo-columnar. Nuclear chromatin appears dispersed and
mitotic figures are present. The stromal cells also show
mitotic activity and have ill-defined borders . In
the late proliferative phase the glands increase in size and
appear tortuous with pseudostratification of the epithelium
showing nuclei at different levels. The stromal cells are small
and spindle-shaped similar to predecidual cells.
Cytology. In the early proliferative phase, EBT show glandular cells in cohesive monolayered sheets. They sometimes
appear as straight or twisted tubular structures resembling
glove fingers irregularly sheared at the ends, the so-called
glove-finger pattern. Almost all the tubular
fragments are open at both ends (open type), but a few are
closed at one end (closed type) and have a cup-like, a half
moon, or spherical shape . The nuclei are of uniform size
and shape and have granular chromatin and distinct micronucleoli. Loose aggregates of stromal cells, which have oval
nuclei and poorly defined cytoplasm, can be identified. In the
late proliferative phase, sheets of endometrial cells are highly
cellular with nuclear crowding, denser nuclear chromatin and
frequent mitotic figures. Tubular structures are small and a
glove-finger pattern is frequently seen
The uterine corpus is composed of a modified mucosa
known as the endometrium, a fibromuscular wall called the
myometrium, and a serosal lining. The uterine mucosa can be
divided into two regions: the mucosa of the lower uterine segment (LUS) (isthmus) and the mucosa of the corpus proper
The mucosa of the LUS, located between the endocervix and endometrium, is thinner than that of the fundus
and its glands respond only slightly to hormonal stimulation.
There is a gradual morphologic transition from the isthmic
mucosa to the endocervical mucosa.
During the reproductive years the endometrium of the corpus proper undergoes regular cyclic changes as a response to
the release of the ovarian hormones, estrogen and progesterone.
The endometrium consists of simple tubular glands set in
a cellular vascular stroma. It is composed of a thin basal layer
The structure and activity of a functional endometrium
reflect the pattern of ovarian hormone secretion. The histologic types of glandular cells are columnar or cuboid. The
endometrium undergoes regular growth and maturation and
when the cycle ends, in the absence of pregnancy, shedding
occurs followed by regeneration. The average duration of the
cycle is 28 days. In a normal cycle the postovulatory phase
lasts 14 days. Changes in the length of the cycle are usually
due to the duration of the proliferative phase, which can vary
from 8 to 21 days

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