Pseudo Placentational Endometrial Hyperplasia (PEH) in Female Dog
Virendra Singh Rathore
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Shashank Vishvakarma *
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Pushkar Sharma
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Abhishek Bisen
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Pankaj Kumar Umar
Department of Veterinary Pharmacology & Toxicology, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Prerana Bhoyar
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Rohan Tambade
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Rajesh Bhabhar
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Aeknath Virendra
Department of Animal Reproduction, Gynaecology and Obstetrics, Mumbai Veterinary College, (MAFSU), Mumbai, Maharashtra, India.
Sunil Kumar
Department of Veterinary Pathology, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Miriyala Ruthu Angel
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Ruchi Nirmal
Department of Veterinary Medicine, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Vikas Rulania
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
Riddhi Singh
Department of Veterinary Gynaecology & Obstetrics, College of Veterinary Science & Animal Husbandry (NDVSU), Jabalpur, M.P., 482001, India.
*Author to whom correspondence should be addressed.
Abstract
Pseudo-placentational endometrial hyperplasia (PEH) is a distinct uterine lesion in dogs, exhibiting histological features that mimic normal placental structures. Initially reported by Krainz (1914) through the accidental discovery of organized endometrial responses to intrauterine porcelain balls, PEH has since been recognized as a progesterone-driven pathology most commonly occurring during diestrus. Subsequent experiments confirmed that foreign material inserted into the uterus during diestrus reliably induces deciduoma-like formations. Clinically and pathologically, PEH is distinguishable from cystic endometrial hyperplasia (CEH) by its organized, decidualized architecture. Recent studies have shown that PEH may also arise in the absence of pregnancy, often in cases involving pseudopregnancy, early embryonic resorption or failed implantation. Exogenous progestin administration and prolonged luteal phases are strongly implicated in the pathogenesis. Grossly, PEH presents with ovoid uterine swellings, thickened mucosa and villous protrusions that may occlude the lumen. Histologically, the endometrium demonstrates a three-layered structure: a deep glandular zone, a fibrous connective tissue band and luminal epithelial folds, without fetal tissue. Clinically, bitches may show signs of mucoid or hemorrhagic vaginal discharge, abdominal distension, lethargy and signs mimicking pseudopregnancy. Diagnosis is confirmed by combining clinical history, ultrasonography and definitive histopathology. Despite its distinct features, PEH remains underdiagnosed, often misidentified as CEH or pyometra, underscoring the need for improved recognition and differentiation among uterine pathologies.
Keywords: Pseudo-placentational endometrial hyperplasia, cystic endometrial hyperplasia