Ovarian adenocellular hyperplasia syndrome

　　The etiology and pathogenesis of the ovarian adenocellular hyperplasia syndrome are not yet clear. Since this syndrome has some similarities with polycystic ovary syndrome, such as oligomenorrhea, amenorrhea, hirsutism, obesity, and ovarian enlargement, people used to discuss the two together in the past. The increase in androgens in patients with the ovarian adenocellular hyperplasia syndrome may be related to the deficiency of certain enzymes in the ovary, leading to the disturbance of estrogen production and simultaneously causing hypothalamic-pituitary dysfunction. This seems similar to polycystic ovary syndrome. However, from the pathological and clinical aspects, patients with this syndrome do not have thickened fibrotic capsules, there is a layer of surrounding follicular membrane cell hyperplasia in the ovarian cortex interstitium, and the follicles are mostly primordial follicles, with clinical special male manifestations. Therefore, the pathogenesis of this syndrome needs to be further explored in the future.

　　The ovarian adenocellular hyperplasia syndrome can be observed grossly as the ovary often being bilaterally enlarged, with the maximum diameter reaching 7 cm. The ovarian surface is smooth, milky white, and lustrous, with small cysts protruding to the surface in the cortex, and many scattered small yellow areas can also be seen on the surface, with multiple small cysts filled with clear fluid.
　　Microscopic examination shows that the ovarian surface is interstitial collagenization, with many primordial follicles in between, and early growing follicles. In the deeper areas, there are many cystic follicles of varying sizes, and there is a layer of florigenized proliferative inner follicular membrane cells, with no corpus luteum visible. At a greater distance from the cystic follicles, there are many nests formed by polygonal interstitial follicular membrane cells, which contain lipids inside.

　　The increase of testosterone in patients with ovarian follicular adenoma cell hyperplasia syndrome may be related to the lack of certain enzymes in the ovary, causing estrogen production disorders, increased androgen, and at the same time causing hypothalamic-pituitary dysfunction.

　　The clinical symptoms of ovarian follicular adenoma cell hyperplasia syndrome are similar to those of polycystic ovary syndrome, mainly manifested in the following aspects.
　　1, Menstrual changes, obesity. Most patients with this syndrome initially present with oligomenorrhea, which can eventually lead to amenorrhea and significant obesity.
　　1, Masculinization signs. Patients with this syndrome have hirsutism on the cheeks, chin, and neck, and there may also be beard growth, enlarged Adam's apple, varying degrees of breast atrophy, and clitoral hypertrophy.
　　2, Gynecological examination. The patient's vaginal wall is smooth and atrophic, the cervix is atrophic. During laparotomy, the uterus and fallopian tubes are normal, and the ovaries on both sides are enlarged.

　　Ovarian follicular adenoma cell hyperplasia syndrome is less common, and there is no targeted preventive research. The key points to maintain endocrine balance: Reasonable regulation of dietary structure, low-fat, low-sugar, low-calorie diet, balanced nutrition; Maintain a good mood, bad emotions such as depression, anger, and fear will stimulate fragile nerves, disrupt endocrine regulation, and reduce immune function; Increase the intensity of exercise, appropriate exercise promotes blood circulation in the human body, improves the body's resistance, and is beneficial to endocrine coordination.

　　The clinical manifestations of ovarian follicular adenoma cell hyperplasia syndrome are similar to those of polycystic ovary syndrome, and diagnosis can be made based on the following examination results.
　　Firstly, laboratory examination:
　　1, Blood routine, serum electrolytes, blood urea nitrogen and creatinine are within the normal range.
　　2, The testosterone level of hirsute patients is higher than the average value of normal women, but one-third of the patients with this syndrome may be within the normal range.
　　3, Dexamethasone suppression test is normal, and there may be significant elevation after using chorionic gonadotropin.
　　4, The patient's urine 17-hydroxyl and 17-ketone are normal.
　　5, Oral glucose tolerance test significantly abnormal.
　　Secondly, other auxiliary examinations:Histopathological examination.

　　For patients with ovarian follicular adenoma cell hyperplasia syndrome, the diet should be light and nutritious. The following are several recommended therapeutic diets.

　　1, Guishen Stewed Hen

　　One live young hen,宰杀后取鸡肉，切块，与当归身、党参、生姜同入炖盅，加适量沸水、少许烧酒，炖盅加盖，隔水文火炖3～4 hours, season with taste. Eat the chicken and drink the soup.

　　Function: Tonify Qi and nourish blood, regulate the menstrual cycle. Symptoms include delayed menstruation, scanty, pale, thin, and dilute menstrual flow, yellowish complexion, dizziness, palpitations, or postpartum blood deficiency dizziness.

　　2. Black Chicken Spatholobus Suberectus Soup

　　The carcass of the black chicken is plucked, cleaned of intestines and viscera, cut into pieces, boiled in boiling water for 5 minutes, removed and cooled, then added with Spatholobus suberectus (chopped), ginger, and jujube (with seeds removed) to the pot, add an appropriate amount of water, boil with high heat, then change to low heat and simmer for 2 hours, season and eat.

　　Function: Tonify blood and activate circulation, regulate menstruation. Symptoms include irregular menstruation, less menstrual flow, purple-red color, blood clots, abdominal pain, yellowish complexion, dizziness and palpitations. It can also be used for anemia after hemorrhage.

　　3. Pigeon Turtle Shell Soup

　　1 pigeon, plucked and cleaned of internal organs, the turtle shell crushed and placed in the pigeon's abdomen, add 1 liter of water to the pot, boil with high heat, then change to low heat and simmer for 1-2 hours until the pigeon meat is tender and season it. Eat the meat and drink the soup, 1 time/day.

　　Function: Symptoms include irregular menstruation, delayed menstruation, soreness in the loins and knees, afternoon feverishness, hot palms and soles, night sweats, irritability and anger, insomnia and dreams.

　　The following points should be noted in the treatment process of the syndrome of follicular adenocellular hyperplasia:

　　1. Early detection, timely treatment, and good follow-up. Adjust the diet structure, low-fat, low-sugar, low-calorie diet, optimize the diet structure, balance nutrients. Keep a good mood, bad emotions such as depression, anger, and fear will stimulate fragile nerves, disrupt endocrine regulation, and reduce immune function.

　　2. Increase the intensity of exercise, appropriate exercise promotes human blood circulation, improves the body's resistance, and is beneficial to endocrine coordination. Traditional Chinese medicine treatment methods for the syndrome of follicular adenocellular hyperplasia, Western medicine treatment methods for the syndrome of follicular adenocellular hyperplasia

　　3. Drug Treatment: There is currently no specific treatment for this syndrome to make it ovulate or return to normal menstruation. For those with significant symptoms, prednisone can be given, especially more suitable for those with hirsutism and androgenic manifestations.

　　4. Surgical Treatment: The ovary can be surgically removed, that is, a wedge resection of part of the ovary, with significant efficacy. Most patients ovulate and become pregnant quickly after surgery. Ovarian wedge resection is rarely used now, only reserved for those who are ineffective with drug treatment and symptoms do not subside. Estrogen therapy is given after surgery to maintain and keep sexual development.

　　The syndrome of follicular adenocellular hyperplasia is rare. There is no obvious adverse prognosis.