A 31-year-old woman with PCOS has prolonged oligomenorrhea with intervals of 4 to 6 months. Endometrial sampling is planned. The histological change she is at greatest risk of developing, and its cause, is:

• A Simple and complex hyperplasia due to chronic unopposed estrogen ✓
• B Atrophic endometrium due to hypoestrogenism
• C Secretory endometrium due to luteinized unruptured follicles
• D Asherman syndrome due to adhesion formation

Explanation

Chronic anovulation in PCOS means no corpus luteum forms and no progesterone is secreted. Estradiol from peripheral aromatisation and ovarian theca cells acts on the endometrium unopposed, driving simple then complex hyperplasia and raising carcinoma risk. Atrophy requires low estrogen, secretory change requires progesterone exposure, and Asherman syndrome follows curettage infection, none of which apply here.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.