The epithelium is to some extent pseudostratified and several mitoses are present. There is no atypia, although there is some degree of nuclear variation. There are many areas with squamous cell metaplasia (might be hard to see in this computer image).

Question 1: Why is the ratio of epithelial cells to stroma so high?

- because the epithelial cells divide more rapidly under the influence of prolonged estrogen stimulation. The gland folds and twists and get their caracteristic look as seen in this image. The lack of stroma makes the gland laying "back-to-back".

Question 2: What clinical conditions is associated with complex hyperplasia?

- anovularory cycles, obesity, granulosacell tumor