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Microglandular hyperplasia

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Microglandular hyperplasia (MGH) of the cervix is an epithelial (endocervical mucosa) benign abnormality (lesion) associated with gland proliferation.[1][2] It can terminate in mature squamous metaplasia, and it is suspected reserve cells are involved in this process, perhaps in the form of reserve cell hyperplasia with glandular differentiation.[1][3][4][5]

Diagnosis

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MGH shows certain cytomorphologic features from pap smears, such as bi- or tridimensional cellular clusters consisting of glandular cells with vacuolated cytoplasm together with reserve cells with scant cytoplasm.[5][6] These features however are not characteristic exclusively to MGH, often being present in adenocarcinoma-affected tissue as well, and these tissues can be found merged with MGH areas. This results in difficulty distinguishing between endocervical lesions, and as such should not be used for diagnostic purposes.[6][7][8][9][10]

The presence of subnuclear vacuoles is often observed in MGH, whereas squamous metaplasia, stromal foam cells, mitotic activity, vimentin and MIB‐1 expression are rather more often observed in adenocarcinoma.[11][12]

Incidence

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MGH is often observed idiopathically in pregnant women, as well as women exposed to diethylstilbestrol both as a contraceptive or in-utero, however this association is not statistically significant.[13][14] It has been suggested that HPV infection is an initial step towards the carcinogenesis in these lesions.[15]

See also

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References

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  1. ^ a b Witkiewicz AK, Hecht JL, Cviko A, McKeon FD, Ince TA, Crum CP (2005). "Microglandular hyperplasia: a model for the de novo emergence and evolution of endocervical reserve cells". Hum. Pathol. 36 (2): 154–61. doi:10.1016/j.humpath.2004.10.017. PMID 15754292.
  2. ^ Daniele E, Nuara R, Morello V, Nagar C, Tralongo V, Tomasino RM (1993). "[Micro-glandular hyperplasia of the uterine cervix. Histo-cytopathological evaluation, differential diagnosis and review of literature]". Pathologica. 85 (1100): 607–35. PMID 8170711.
  3. ^ Chumas JC, Nelson B, Mann WJ, Chalas E, Kaplan CG (1985). "Microglandular hyperplasia of the uterine cervix". Obstet Gynecol. 66 (3): 406–9. PMID 4022499.
  4. ^ Martens JE, Smedts F, van Muyden RC, Schoots C, Helmerhorst TJ, Hopman A, et al. (2007). "Reserve cells in human uterine cervical epithelium are derived from müllerian epithelium at midgestational age". Int. J. Gynecol. Pathol. 26 (4): 463–8. doi:10.1097/pgp.0b013e31803c7c18. PMID 17885499. S2CID 19701214.
  5. ^ a b Alvarez-Santín, Carmen; Sica, Adela; Rodríguez, María Carmen; Feijó, Alicia; Garrido, Grisel (1999). "Microglandular Hyperplasia of the Uterine Cervix". Acta Cytologica. 43 (2): 110–113. doi:10.1159/000330961. ISSN 1938-2650. PMID 10097694. S2CID 3360423.
  6. ^ a b Valente, Philip T.; Schantz, H. Daniel; Schultz, Monica (1994). "Cytologic atypia associated with microglandular hyperplasia". Diagnostic Cytopathology. 10 (4): 326–331. doi:10.1002/dc.2840100407. ISSN 8755-1039. PMID 7924805. S2CID 39895781.
  7. ^ Silverberg SG (2000). "Problems in the differential diagnosis of endometrial hyperplasia and carcinoma". Mod. Pathol. 13 (3): 309–27. doi:10.1038/modpathol.3880053. PMID 10757341.
  8. ^ Cameron RI, Maxwell P, Jenkins D, McCluggage WG (2002). "Immunohistochemical staining with MIB1, bcl2 and p16 assists in the distinction of cervical glandular intraepithelial neoplasia from tubo-endometrial metaplasia, endometriosis and microglandular hyperplasia". Histopathology. 41 (4): 313–21. doi:10.1046/j.1365-2559.2002.01465.x. PMID 12383213.
  9. ^ Young RH, Scully RE (1992). "Uterine carcinomas simulating microglandular hyperplasia. A report of six cases". Am. J. Surg. Pathol. 16 (11): 1092–7. doi:10.1097/00000478-199211000-00008. PMID 1471729. S2CID 21549513.
  10. ^ Yahr, Laura J.; Lee, Kenneth R. (1991). "Cytologic findings in microglandular hyperplasia of the cervix". Diagnostic Cytopathology. 7 (3): 248–251. doi:10.1002/dc.2840070308. ISSN 8755-1039. PMID 1879260. S2CID 9072204.
  11. ^ Qiu, Wansong; Mittal, Khush (2003). "Comparison of Morphologic and Immunohistochemical Features of Cervical Microglandular Hyperplasia with Low-grade Mucinous Adenocarcinoma of the Endometrium". International Journal of Gynecological Pathology. 22 (3): 261–265. doi:10.1097/01.PGP.0000071043.12278.8D. ISSN 0277-1691. PMID 12819393. S2CID 26010265.
  12. ^ Florescu M, Simionescu C, Georgescu CV, Marinescu M (1999). "Histopathologic aspects in microglandular hyperplasia of endocervix". Rom J Morphol Embryol. 45: 181–4. PMID 15847393.
  13. ^ Wilkinson E, Dufour DR (1976). "Pathogenesis of microglandular hyperplasia of the cervix uteri". Obstet Gynecol. 47 (2): 189–95. PMID 1250541.
  14. ^ Greeley C, Schroeder S, Silverberg SG (1995). "Microglandular hyperplasia of the cervix: a true "pill" lesion?". Int. J. Gynecol. Pathol. 14 (1): 50–4. doi:10.1097/00004347-199501000-00009. PMID 7883426.
  15. ^ Tase T, Okagaki T, Clark BA, Twiggs LB, Ostrow RS, Faras AJ (1989). "Human papillomavirus DNA in glandular dysplasia and microglandular hyperplasia: presumed precursors of adenocarcinoma of the uterine cervix". Obstet Gynecol. 73 (6): 1005–8. doi:10.1097/00006250-198906000-00020. PMID 2542853. S2CID 21791825.

Further reading

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  • Speers WC, Picaso LG, Silverberg SG (1983). "Immunohistochemical localization of carcinoembryonic antigen in microglandular hyperplasia and adenocarcinoma of the endocervix". American Journal of Clinical Pathology. 79 (1): 105–7. doi:10.1093/ajcp/79.1.105. PMID 6336881.
  • Zaloudek C, Hayashi GM, Ryan IP, Powell CB, Miller TR (1997). "Microglandular adenocarcinoma of the endometrium: a form of mucinous adenocarcinoma that may be confused with microglandular hyperplasia of the cervix". Int. J. Gynecol. Pathol. 16 (1): 52–9. doi:10.1097/00004347-199701000-00009. PMID 8986533. S2CID 32772129.
  • Jones MW, Silverberg SG (1989). "Cervical adenocarcinoma in young women: possible relationship to microglandular hyperplasia and use of oral contraceptives". Obstet. Gynecol. 73 (6): 984–9. doi:10.1097/00006250-198906000-00015. PMID 2726119.
  • Robboy SJ, Welch WR (1977). "Microglandular hyperplasia in vaginal adenosis associated with oral contraceptives and prenatal diethylstilbestrol exposure". Obstet Gynecol. 49 (4): 430–4. PMID 857207.
  • Nichols TM, Fidler HK (1971). "Microglandular hyperplasia in cervical cone biopsies taken for suspicious and positive cytology". American Journal of Clinical Pathology. 56 (4): 424–9. doi:10.1093/ajcp/56.4.424. PMID 5113397.
  • Young RH, Scully RE (1989). "Atypical forms of microglandular hyperplasia of the cervix simulating carcinoma. A report of five cases and review of the literature". Am. J. Surg. Pathol. 13 (1): 50–6. doi:10.1097/00000478-198901000-00007. PMID 2535775. S2CID 8577678.
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