Difference between revisions of "Uterine cervix"

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Uterine cervix (view source)

Revision as of 01:35, 19 December 2013

4,491 bytes removed ,  01:35, 19 December 2013
→‎Microglandular hyperplasia: split out
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*Abbreviated ''MGH''.
*Abbreviated ''MGH''.
*[[AKA]] ''microglandular change''.
*[[AKA]] ''microglandular change''.
===General===
{{Main|Microglandular hyperplasia}}
*Associated with [[OCP]] use.<ref name=pmid10757337>{{Cite journal  | last1 = Zaino | first1 = RJ. | title = Glandular lesions of the uterine cervix. | journal = Mod Pathol | volume = 13 | issue = 3 | pages = 261-74 | month = Mar | year = 2000 | doi = 10.1038/modpathol.3880047 | PMID = 10757337 | URL = http://www.nature.com/modpathol/journal/v13/n3/full/3880047a.html }}</ref>
*May be confused with adenocarcinoma.<ref name=pmid7234352>{{Cite journal  | last1 = Jobo | first1 = T. | last2 = Kuramoto | first2 = H. | last3 = Morisawa | first3 = T. | title = [Microglandular hyperplasia of the cervix: reevaluation of the polyp (author's transl)]. | journal = Acta Obstet Gynaecol Jpn | volume = 33 | issue = 5 | pages = 651-8 | month = May | year = 1981 | doi =  | PMID = 7234352 }}</ref>
===Gross===
Features:
*Yellowish polypoid/papillary lesion.<ref name=cxhealth>URL: [http://www.cervicalhealth.com/colposcopy.php http://www.cervicalhealth.com/colposcopy.php]. Accessed on: 18 December 2013.</ref><ref name=pmid7234352/>
 
Images:
*[http://www.cervicalhealth.com/colposcopy.php MGH at colposcopy (cervicalhealth.com)].<ref name=cxhealth/>
 
===Microscopic===
Features:<ref name=pmid10757337/>
*Cytologically benign - '''important'''.
**Usually cuboidal morphology.
**Typically clear cytoplasm.
*Crowded small glands (classic), reticular or solid.
 
Significant negatives:
*Nuclear atypia absent.
*[[NC ratio]] not significantly increased.
 
DDx:
*[[Endocervical adenocarcinoma in situ|Adenocarcinoma in situ of the uterine cervix]].
*Endometrial mucinous microglandular adenocarcinoma - very rare.<ref name=pmid16306789>{{Cite journal  | last1 = Giordano | first1 = G. | last2 = D'Adda | first2 = T. | last3 = Gnetti | first3 = L. | last4 = Merisio | first4 = C. | last5 = Melpignano | first5 = M. | title = Endometrial mucinous microglandular adenocarcinoma: morphologic, immunohistochemical features, and emphasis in the human papillomavirus status. | journal = Int J Gynecol Pathol | volume = 25 | issue = 1 | pages = 77-82 | month = Jan | year = 2006 | doi =  | PMID = 16306789 }}</ref><ref name=pmid12808571>{{Cite journal  | last1 = Zamecnik | first1 = M. | last2 = Skalova | first2 = A. | last3 = Opatrny | first3 = V. | title = Microglandular adenocarcinoma of the uterus mimicking microglandular cervical hyperplasia. | journal = Ann Diagn Pathol | volume = 7 | issue = 3 | pages = 180-6 | month = Jun | year = 2003 | doi =  | PMID = 12808571 }}</ref>
*[[Clear cell carcinoma of the uterine cervix]].<ref name=pmid22885379>{{Cite journal  | last1 = Offman | first1 = SL. | last2 = Longacre | first2 = TA. | title = Clear cell carcinoma of the female genital tract (not everything is as clear as it seems). | journal = Adv Anat Pathol | volume = 19 | issue = 5 | pages = 296-312 | month = Sep | year = 2012 | doi = 10.1097/PAP.0b013e31826663b1 | PMID = 22885379 }}</ref>
 
Images:
*[http://www.nature.com/modpathol/journal/v13/n3/fig_tab/3880047f14.html#figure-title MGH (nature.com)].
*[http://sunnybrook.ca/uploads/cx_MGH_5_vd.jpg MGH (sunnybrook.ca)].<ref>URL: [http://sunnybrook.ca/content/?page=Dept_LabS_APath_GynPath_ImgAt_Cvx_neo_micro http://sunnybrook.ca/content/?page=Dept_LabS_APath_GynPath_ImgAt_Cvx_neo_micro]. Accessed on: 25 February 2012.</ref>
 
===IHC===
Features:<ref name=pmid12819393>{{Cite journal  | last1 = Qiu | first1 = W. | last2 = Mittal | first2 = K. | title = Comparison of morphologic and immunohistochemical features of cervical microglandular hyperplasia with low-grade mucinous adenocarcinoma of the endometrium. | journal = Int J Gynecol Pathol | volume = 22 | issue = 3 | pages = 261-5 | month = Jul | year = 2003 | doi = 10.1097/01.PGP.0000071043.12278.8D | PMID = 12819393 }}</ref>
*Ki-67 ~ 0.5% cells.
*Vimentin -ve.
*PR +ve ~ 60% of cases.
*ER +ve/-ve.
 
Others:<ref name=pmid12819393/>
*p53 -ve.
*CEA -ve.
*p16 -ve (scattered cells +ve).{{fact}}
 
===Sign out===
<pre>
UTERINE ENDOCERVIX, CURETTAGE:
- MICROGLANDULAR HYPERPLASIA.
- SQUAMOUS EPITHELIUM WITH REACTIVE CHANGES AND METAPLASTIC CHANGES.
</pre>
 
====Micro====
The sections show gland forming epithelium without nuclear atypia (no nuclear membrane
irregularities, no coarse chromatin). The nuclei are less than 2x the size of a neutrophil,
regularly spaced, pale staining and have small regular nucleoli visible with the 20x
objective. No mitotic activity is apparent.
 
Fragments of reactive squamous epithelium with metaplastic changes are present. Benign
superficial squamous epithelium is identified.


==Wolffian duct hyperplasia==
==Wolffian duct hyperplasia==
Michael
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