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Difference between revisions of "Cervical polyps"
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'''Cervical polyps''' are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign. | '''Cervical polyps''' are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign. An introduction to the ''uterine cervix'' is in the [[uterine cervix]] article. | ||
==Benign endocervical | ==Benign endocervical polyp== | ||
=== | :''Endocervical polyp'' redirects here. | ||
===General=== | |||
*Usually 30-50 years old. | *Usually 30-50 years old. | ||
* | *May cause bleeding. | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref>URL: [http://pathologyoutlines.com/cervix.html#endocervpolyp http://pathologyoutlines.com/cervix.html#endocervpolyp]. Accessed on: 22 October 2011.</ref> | ||
*May have mixed epithelium, i.e. squamous and endocervical type (with eosinophilic mucin). | *May have mixed epithelium, i.e. squamous and endocervical type (with eosinophilic mucin). | ||
**Endocervical epithelium should have nuclei like that in the colon, i.e. small, round & basal. | **Endocervical epithelium should have nuclei like that in the colon, i.e. small, round & basal. | ||
| Line 22: | Line 23: | ||
*No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp." | *No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp." | ||
DDx: | |||
*[[Benign endometrial polyp]]. | |||
*[[Fibroepithelial stromal polyp]]. | |||
*[[Adenosarcoma]]. | |||
*[[Papillary adenofibroma of the uterine cervix]].<ref name=pmid8927449>{{Cite journal | last1 = Fratini | first1 = D. | last2 = Cavaliere | first2 = A. | title = Papillary adenofibroma of the uterine cervix. A case report. | journal = Pathologica | volume = 88 | issue = 2 | pages = 135-6 | month = Apr | year = 1996 | doi = | PMID = 8927449 }}</ref> | |||
*[[Nabothian cyst]]s. | |||
====Images==== | |||
<gallery> | |||
Image: Xanthomatous endocervical polyp -- low mag.jpg | EP - low mag. | |||
Image: Xanthomatous endocervical polyp -- intermed mag.jpg | EP - intermed. mag. | |||
</gallery> | |||
===Sign out=== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP. | |||
</pre> | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION. | |||
</pre> | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH AN EROSION AND INFLAMMATION. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Significant squamous epithelium present==== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- BENIGN CERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION. | |||
</pre> | |||
====History provided==== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- BENIGN ENDOCERVICAL POLYP. | |||
</pre> | |||
==Papillary adenofibroma of the uterine cervix== | |||
*[[AKA]] ''cervical papillary adenofibroma''.<ref name=pmid16041681>{{Cite journal | last1 = Haberal | first1 = A. | last2 = Cil | first2 = AP. | last3 = Gunes | first3 = M. | last4 = Cavusoglu | first4 = D. | title = Papillary adenofibroma of the cervix: a case report. | journal = Ultrasound Obstet Gynecol | volume = 26 | issue = 2 | pages = 186-7 | month = Aug | year = 2005 | doi = 10.1002/uog.1948 | PMID = 16041681 }}</ref> | |||
===General=== | |||
*Rare.<ref name=pmid8927449>{{Cite journal | last1 = Fratini | first1 = D. | last2 = Cavaliere | first2 = A. | title = Papillary adenofibroma of the uterine cervix. A case report. | journal = Pathologica | volume = 88 | issue = 2 | pages = 135-6 | month = Apr | year = 1996 | doi = | PMID = 8927449 }}</ref> | |||
Clinical:<ref name=pmid8927449/> | |||
*[[Menorrhagia]]. | |||
===Gross=== | |||
*Polypoid mass. | |||
DDx: | |||
*[[Benign endocervical polyp]]. | |||
===Microscopic=== | |||
Features: | |||
*Branching nipple like projections (papillae) covered by endocervical epithelium +/- metaplastic squamous epithelium. | |||
*Fibrous stroma. | |||
DDx: | |||
*[[Adenosarcoma]]. | |||
==Fibroepithelial stromal polyp== | ==Fibroepithelial stromal polyp== | ||
| Line 29: | Line 92: | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid10680891/> | Features:<ref name=pmid10680891/> | ||
*Bland nuclei. | *Bland nuclei. | ||
*Hypocellular. | *Hypocellular. | ||
<br> | |||
Note: | |||
*The Foundation series books appears to lump together ''fibroepithelial stromal polyp'' and ''pseudosarcomatous fibroepithelial stromal polyp''. | |||
**Features as per ''Foundation series'' book:<ref>{{Ref GP|31}}</ref> | |||
***Polypoid lesions. | |||
***Squamous epithelium. | |||
***Variable cellularity. | |||
***Multinucleated cells. | |||
Image: | |||
* | *[http://www.surgpath4u.com/caseviewer.php?case_no=450 FSP (surgpath4u.com)]. | ||
==Pseudosarcomatous fibroepithelial stromal polyp== | ==Pseudosarcomatous fibroepithelial stromal polyp== | ||
| Line 56: | Line 123: | ||
*No identifiable margin between lesion and normal - important feature. | *No identifiable margin between lesion and normal - important feature. | ||
*Scattered multinucleated stromal cells - usu. close to epithelium. | *Scattered multinucleated stromal cells - usu. close to epithelium. | ||
DDx: | |||
*[[Adenosarcoma]]. | |||
===IHC=== | ===IHC=== | ||
*Desmin +ve (common). | *Desmin +ve (common). | ||
*SMA usu. -ve. | *SMA usu. -ve. | ||
==Adenosarcoma== | ==Adenosarcoma== | ||
{{Main|Adenosarcoma}} | {{Main|Adenosarcoma}} | ||
| Line 67: | Line 137: | ||
*[[Cervix]]. | *[[Cervix]]. | ||
*[[Endometrial polyp]]. | *[[Endometrial polyp]]. | ||
*[[ | *[[Gynecologic pathology]]. | ||
==References== | ==References== | ||