Microglandular hyperplasia of the uterine cervix

Microglandular hyperplasia of the uterine cervix is a relatively common benign finding the uterine cervix that may be confused with malignancy.

It is also simply known microglandular hyperplasia, abbreviated MGH, is also known as microglandular change

It should not to be confused with microglandular adenosis.

General

• Associated with OCP use.
• May be confused with adenocarcinoma.

Gross

Features:

• Yellowish polypoid/papillary lesion.

Images:

• MGH at colposcopy (cervicalhealth.com).

Microscopic

Features:

• 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:

• Adenocarcinoma in situ of the uterine cervix.
• Endometrial mucinous microglandular adenocarcinoma - very rare.
• Clear cell carcinoma of the uterine cervix.

Images

www:

• MGH (nature.com).
• MGH (sunnybrook.ca).

IHC

Features:

• Ki-67 ~ 0.5% cells.
• Vimentin -ve.
• PR +ve ~ 60% of cases.
• ER +ve/-ve.

Others:

• p53 -ve.
• CEA -ve.
• p16 -ve (scattered cells +ve).^{[citation needed]}

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UTERINE ENDOCERVIX, CURETTAGE: 
- MICROGLANDULAR HYPERPLASIA. 
- SQUAMOUS EPITHELIUM WITH REACTIVE CHANGES AND METAPLASTIC CHANGES.

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.

See also

• Uterine cervix.