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. An introduction to the uterine cervix is in the uterine cervix article.

Benign endocervical polyp

Endocervical polyp redirects here.

General

  • Usually 30-50 years old.
  • May cause bleeding.

Microscopic

Features:[1]

  • 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.
  • Polypoid shape.
  • +/-Inflammation.
  • +/-Squamous metaplasia.

Negatives:

  • No mitoses.
  • No nuclear atypia.
  • No stromal proliferation.

Notes:

  • No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp."

DDx:

Images

Sign out

CERVICAL POLYP, EXCISION:
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP.
CERVICAL POLYP, EXCISION:
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION.
CERVICAL POLYP, EXCISION:
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH AN EROSION AND INFLAMMATION.
- NEGATIVE FOR MALIGNANCY.

Significant squamous epithelium present

CERVICAL POLYP, EXCISION:
- BENIGN CERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION.

History provided

CERVICAL POLYP, EXCISION:
- BENIGN ENDOCERVICAL POLYP.

Papillary adenofibroma of the uterine cervix

  • AKA cervical papillary adenofibroma.[3]

General

Clinical:[2]

Gross

  • Polypoid mass.

DDx:

Microscopic

Features:

  • Branching nipple like projections (papillae) covered by endocervical epithelium +/- metaplastic squamous epithelium.
  • Fibrous stroma.

DDx:

Fibroepithelial stromal polyp

General

  • Usually easy to recognize.[4]

Microscopic

Features:[4]

  • Bland nuclei.
  • Hypocellular.


Note:

  • The Foundation series books appears to lump together fibroepithelial stromal polyp and pseudosarcomatous fibroepithelial stromal polyp.
    • Features as per Foundation series book:[5]
      • Polypoid lesions.
      • Squamous epithelium.
      • Variable cellularity.
      • Multinucleated cells.

Image:

Pseudosarcomatous fibroepithelial stromal polyp

General

  • Uncommon.
  • Wide age range.
  • May be misdiagnosed as a sarcoma and overtreated.[4]
  • Similar lesions in vagina and vulva.

Microscopic

Features:[4]

  • Hypercellularity.
  • Marked nuclear pleomorphism (common).
  • +/-High mitotic rate ( > 10 mitoses / 10 HPF).
  • +/-Atypical mitoses.
  • No identifiable margin between lesion and normal - important feature.
  • Scattered multinucleated stromal cells - usu. close to epithelium.

DDx:

IHC

  • Desmin +ve (common).
  • SMA usu. -ve.

Adenosarcoma

See also

References

  1. URL: http://pathologyoutlines.com/cervix.html#endocervpolyp. Accessed on: 22 October 2011.
  2. 2.0 2.1 2.2 Fratini, D.; Cavaliere, A. (Apr 1996). "Papillary adenofibroma of the uterine cervix. A case report.". Pathologica 88 (2): 135-6. PMID 8927449.
  3. Haberal, A.; Cil, AP.; Gunes, M.; Cavusoglu, D. (Aug 2005). "Papillary adenofibroma of the cervix: a case report.". Ultrasound Obstet Gynecol 26 (2): 186-7. doi:10.1002/uog.1948. PMID 16041681.
  4. 4.0 4.1 4.2 4.3 Nucci, MR.; Young, RH.; Fletcher, CD. (Feb 2000). "Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma.". Am J Surg Pathol 24 (2): 231-40. PMID 10680891.
  5. Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 31. ISBN 978-0443069208.