Microglandular hyperplasia of the uterine cervix

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Microglandular hyperplasia of the uterine cervix
Diagnosis in short

Microglandular hyperplasia. H&E stain.
LM crowded small glands (classic), reticular or solid, cytologically benign - usually cuboidal morphology, typically clear cytoplasm
LM DDx adenocarcinoma in situ of the uterine cervix, endometrial mucinous microglandular adenocarcinoma, clear cell carcinoma of the uterine cervix
Site uterine cervix
Associated Dx OCP use
Prevalence common
Prognosis benign

Microglandular hyperplasia of the uterine cervix is a relatively common benign finding of the uterine cervix that may be confused with malignancy, especially endocervical adenocarcinoma. It is usually referred to simply as microglandular hyperplasia, abbreviated MGH, and is also known as microglandular change.

It should not to be confused with microglandular adenosis.

General

  • Associated with OCP use.[1]
  • May be confused with adenocarcinoma.[2]

Gross

Features:

  • Yellowish polypoid/papillary lesion.[3][2]

Images:

Microscopic

Features:[1]

  • 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:

Images

  • MGH - low mag.

  • MGH - intermed. mag.

  • MGH - high mag.

  • MGH - high mag.

  • MGH - high mag.

www:

IHC

Features:[8]

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

Others:[8]

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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

References

  1. ↑ 1.0 1.1 Zaino, RJ. (Mar 2000). "Glandular lesions of the uterine cervix.". Mod Pathol 13 (3): 261-74. doi:10.1038/modpathol.3880047. PMID 10757337.
  2. ↑ 2.0 2.1 Jobo, T.; Kuramoto, H.; Morisawa, T. (May 1981). "[Microglandular hyperplasia of the cervix: reevaluation of the polyp (author's transl)].". Acta Obstet Gynaecol Jpn 33 (5): 651-8. PMID 7234352.
  3. ↑ 3.0 3.1 URL: http://www.cervicalhealth.com/colposcopy.php. Accessed on: 18 December 2013.
  4. ↑ Giordano, G.; D'Adda, T.; Gnetti, L.; Merisio, C.; Melpignano, M. (Jan 2006). "Endometrial mucinous microglandular adenocarcinoma: morphologic, immunohistochemical features, and emphasis in the human papillomavirus status.". Int J Gynecol Pathol 25 (1): 77-82. PMID 16306789.
  5. ↑ Zamecnik, M.; Skalova, A.; Opatrny, V. (Jun 2003). "Microglandular adenocarcinoma of the uterus mimicking microglandular cervical hyperplasia.". Ann Diagn Pathol 7 (3): 180-6. PMID 12808571.
  6. ↑ Offman, SL.; Longacre, TA. (Sep 2012). "Clear cell carcinoma of the female genital tract (not everything is as clear as it seems).". Adv Anat Pathol 19 (5): 296-312. doi:10.1097/PAP.0b013e31826663b1. PMID 22885379.
  7. ↑ URL: http://sunnybrook.ca/content/?page=Dept_LabS_APath_GynPath_ImgAt_Cvx_neo_micro. Accessed on: 25 February 2012.
  8. ↑ 8.0 8.1 Qiu, W.; Mittal, K. (Jul 2003). "Comparison of morphologic and immunohistochemical features of cervical microglandular hyperplasia with low-grade mucinous adenocarcinoma of the endometrium.". Int J Gynecol Pathol 22 (3): 261-5. doi:10.1097/01.PGP.0000071043.12278.8D. PMID 12819393.
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