- Source: Microglandular hyperplasia
Microglandular hyperplasia (MGH) of the cervix is an epithelial (endocervical mucosa) benign abnormality (lesion) associated with gland proliferation. 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.
Diagnosis
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. 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.
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.
Incidence
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. It has been suggested that HPV infection is an initial step towards the carcinogenesis in these lesions.
See also
Vaginal adenosis
References
Further reading
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.
