Microglandular Hyperplasia of the Endocervix [72480

With increasing potency of the gestagen used, endocervical glandular proliferation is more likely to develop into microalveolar changes with disappearance of the intervening stroma (Figs. 63-65). The low cuboidal, undifferentiated, glandular epithelial cells can hardly be distinguished from the surrounding hyperplastic reserve cells. Occasionally a solid sheetlike proliferation of reserve cells, signet-ring cells or hobnail cells may be observed. These changes, too, may be misdiagnosed as invasive adenocarcinoma or clear cell carcinoma (Taylor et al. 1967; Candy and Abell 1968; Kyriakos et al. 1968; Talbert and Shery 1969; Helmerhorst et al. 1984; Wells and Brown 1986; Young and Scully 1989).

■ Differential Diagnosis. Several features may help to differentiate a microglandular hy-perplasia from an invasive carcinoma. The cells of microglandular hyperplasia show less nuclear atypia, they have a low proliferation index (MIB-1) and their cytoplasm contains mucin, not glycogen. In contrast to invasive adenocarcinoma, microglandular hyperplasia reacts negatively for CEA and for p16INK4a.

Microglandular Adenocarcinoma
Fig. 63. Microglandular hyperplasia of endocervix. H&E
Ecto Endocervix
Fig. 65. Microglandular hyperplasia of endocervix. H&E, higher magnification

Glandular Papillary Ectropion (Fig. 66)

As a result of excessive proliferation and growth pressure, the endocervical mucosa frequently protrudes onto the ectocervical surface (Fig. 66). Under gestagenic stimulation, epidermization of such an ectropion is usually initiated by reserve cell hyperplasia ("descending repair," p. 24).

Ecto Endocervix
Fig. 66. Eversion (protrusion) of hyperplastic endocervical mucosa onto the ectocervical surface with epidermization (descending repair). H&E

Polyps of the Ecto- and Endocervix (Figs. 67-69)

Focal proliferation of the endocervical mucosa leads to polyp formation. Depending upon their glands, they may be either cystic (Fig. 67), adenomatous, or microglandular; depending upon their stromal content, they may be either fibrous, angiomatous (Fig. 68), edematous (Fig. 67), or cellular (Fig. 68). Their surface may be papillary (Fig. 67) or smooth (Fig. 68). When these polyps protrude through the external os, the surface epithelium may be replaced by reserve cell hyperplasia (Fig. 68), which can differentiate to squamous metaplasia and finally to mature stratified squamous epithelium. When such polyps are completely overgrown by squamous epithelium, they are then classified as ectocervical polyps (Fig. 69).

Endocervical Polyp Microscopy
Fig. 68. Endocervical polyp with angiomatous, cellular stroma, covered by reserve cell hyperplasia. H&E
Endocervical Polyp
Fig. 69. Ectocervical polyp. H&E

Was this article helpful?

0 0
10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


  • Magnus
    What is microglandular hyperplasia?
    7 years ago
  • osman kifle
    6 years ago
  • Anna
    What is what is focal Microglandular hyperplasia and squamous metaplasia."?
    5 years ago
  • ilberic tunnelly
    What is complex hyperplasia with squamous metaplasia?
    4 years ago
  • Ramsay
    What is hyperplastic ectocervix?
    4 years ago
  • Mira
    What is nedocervicitis with mircoglandular hyperplasia, squamous metaplasia?
    10 months ago

Post a comment