Microglandular hyperplasia a complicating factor in the diagnosis. It is of no major clinical significance, but clinicians may not be familiar with it. It has been reported to occur in association with progestational stimulation, but this has not been well studied. Microglandular hyperplasia of uterine cervix dovemed. A contemporary approach to pathologic diagnosis of endometrial cancer joseph t rabban md mph associate professor, department of pathology university of california san francisco joseph. Breast nonmalignant microglandular adenosis of breast. Atypical endometrial hyperplasia this may also be simple or complex.
Aug 12, 2008 atypical adenomatous hyperplasia aah or adenosis of the prostate is a pseudoneoplastic lesion that can mimic prostate adenocarcinoma because of its cytologic and architectural features. Pdf although endocervical microglandular hyperplasia mgh is a common diagnosis, it can be confused with adenocarcinoma aca. The following case points out the clinical and patho logical dilemma, which may arise in the appropriate management of this type of lesion. What is focal endocervical microglandular hyperplasia and what does it mean. Cytologic atypia associated with microglandular hyperplasia. Microglandular endocervical hyperplasia definition of. Earlier, it seemed that mgh could be confused with malignancy, but that the malignancy can. It is benign breast condition although can mimic a breast cancer particularly tubular breast carcinoma 3,5 both clinically, radiology and pathologically pathology. For many years, it has been assumed that microglandular hyperplasia mgh of the cervix occurs almost exclusively in women with endogenous pregnancy or exogenous oral contraceptives progestational stimulation, but this relationship has never been subjected to rigorous epidemiologic study. Pdf to identify cytomorphologic features specific to microglandular hyperplasia mgh in cervical cytologic smears. Pathology outlines microglandular adenosis of breast. Surface epithelial changes in uterine endometrioid. Microglandular hyperplasia of the endocervix may possibly be confused with endocervical adenocarcinoma.
Association of cervical microglandular hyperplasia with. Media in category histopathology of the female reproductive system the following 160 files are in this category, out of 160 total. Pathology of endometrial hyperplasia and carcinoma obgyn key. Association of cervical microglandular hyperplasia with exogenous progestin exposure. Carcinoma, in situ and invasive, has been reported in association with microglandular adenosis reported in up to 27%. Uterine carcinomas simulating microglandular hyperplasia. Cone procedure, regardless of ais, early or deep invasion if specimen is a biopsy and tumor is clinically visible. The utility of immunohistochemistry in the differential.
For many years, atypical epithelial lesions of the prostate have been known to occur, but much refining of this knowledge has evolved over the last two decades. Cervical microglandular hyperplasia new doctor insights. Apparently disproportionate numbers of metaplastic, adenoid cystic and basallike carcinomas. Endocervical curettage is recommended at the time of excisional biopsy in suspected glandular abnormalities. Microglandular hyperplasia is a reactive process of. Microglandular adenosis of the breast radiology reference. All available cases of mgh in our 1990 surgical pathology files were. Printable microglandular adenosis of the breast surgical.
Microglandular hyperplasia mgh of the cervix is an epithelial endocervical mucosa benign abnormality lesion associated with gland proliferation. Microglandular hyperplasia of the uterine cervix libre. Microglandular hyperplasia definition of microglandular. Subnuclear vacuoles were seen in 10 cases of mgh but were absent in all ma. It warrants follow up with periodic re biopsy yo make sure nothing else is. Read microglandular adenocarcinoma of the uterus mimicking microglandular cervical hyperplasia, annals of diagnostic pathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available. Ileallymphoidnodular hyperplasia, nonspecific colitis, and pervasive developmental disorder in children aj wakefield, sh murch, aanthony, j linnell, d m casson, m malik, m berelowitz, ap dhillon, m a thomson.
It is considered the only benign breast lesion that lacks a myoepithelial layer 4. Microglandular hyperplasia of the endocervix 72480 last updated on sat, 01 jun 2019 cell differentiation with increasing potency of the gestagen used, endocervical glandular proliferation is more likely to develop into microalveolar changes with. Sep 20, 2012 an acis can be distinguished from adenomatous hyperplasia by its cytological atypias, cellular stratification, densely arranged hyperchromatic nuclei, and by its positive immunostaining reaction for cea fig. A clinicopathologic study of 11 cases with ultrastructural observations. Atypical lobular endocervical glandular hyperplasia legh legh rare, benign proliferation of endocervical glands with gastric differentiation asymptomatic incidental finding or watery discharge 3rd to 7 th decade gross. Indication of microglandular hyperplasia on a pathology report may raise. Although pure mghlike uterine carcinomas are rare 25, a focal microglandular pattern in endometrial endometrioid adenocarcinomas is quite frequent.
Incidence of nonneoplastic cervical pathologies recorded. It is mostly diagnosed in young adult women or during pregnancy. Association of cervical microglandular hyperplasia with exogenous progestin exposure debra heller, md, lena nguyen md, laura t. Microglandular hyperplasia in cervical cone biopsies taken for. Eusebi v, foschini mp, betts cm, gherardi g, millis rr, bussolati g, azzopardi jg.
Postmenopausal women on tamoxifen who are diagnosed with endometrial hyperplasia, even without. The cells of microglandular hyperplasia show less nuclear atypia, they have a low proliferation index mib1 and their cytoplasm contains mucin, not glycogen. But there is a proliferation at the point where the normal structure of the endometrium is interfered. Microglandular hyperplasia mgh of the cervix can mimic cervical and endometrial adenocarcinomas that have a pattern resembling that of mgh, especially in a curettage or biopsy specimen. Ductal and lobular hyperplasia occur at about the same rate, and have about the same effect on breast cancer risk. Microglandular hyperplasia a complicating factor in the. To our best knowledge, this is the twelfth case of uterine carcinoma simulating microglandular hyperplasia in the literature. Cytologic findings in microglandular hyperplasia of the. The effects of the levonorgestrel intrauterine system. It has an infiltrative pattern and the glands are haphazardly distributed in a hypocellular or. Pax2 and cyclin d1 expression in the distinction between cervical microglandular hyperplasia and endometrial microglandular like carcinoma.
Benign prostatic hyperplasia bph is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. Mgh, microglandular hyperplasia the mirena coil is a levonorgestrel releasing intrauterine device that is in widespread use in the uk and elsewhere. The solid growth of clear cell carcinoma displays cells with abundant clear cytoplasm, while the cells in microglandular hyperplasia tend to be smaller and have bland nuclei, containing subnuclear vacuoles and lacking intracytoplasmic glycogen. Atypical adenomatous hyperplasia adenosis of the prostate. It is benign breast condition although can mimic a breast cancer particularly tubular breast carcinoma 3,5 both clinically, radiology and pathologically. Introduction the endometrium lining of the uterus may develop endometrial hyperplasia eh, which includes nonneoplastic entities disordered proliferative endometrium, benign hyperplasia, simple and complex hyperplasias without atypia characterized by a proliferation of endometrial glands of irregular size and shape, and precancerous neoplasms endometrial.
Findings from 25 additional smears from patients with microglandular hyperplasia are reported. Ho f c yt o log i a l st u r n olg journal of cytology. Cytologic diagnosis in cervical smears article pdf available in acta cytologica 432. Simple cystic hyperplasia also should be differentiated from proliferative and disordered endometrium, especially the latter wherein endometrial glands are hyperplastic, but without an increase in volume. The endometrial glands are crowded and separated by relatively scanty stroma, without a and b or with c and d signi. How is microglandular hyperplasia of uterine cervix treated. Microglandular adenosis of the breast surgical pathology.
Microglandular hyperplasia almost always cervical exogenous hormones closely packed glands cuboidal cells, infranuclear vacuoles uniformly bland, few mitoses squamous metaplasia, reserve cell hyperplasia solid, reticular patterns can be more concerning. The treatment measures for microglandular hyperplasia of uterine cervix may include the following. Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and. A report of six cases microglandular endocervical hyperplasia atypical microglandular hyperplasia. Microglandular adenosis mga of the breast is a pathological subtype of mammary adenosis. Transitional atypical microglandular adenosis has been proposed increased irregularity and density of glands. Ductal hyperplasia also called duct epithelial hyperplasia is an overgrowth of the cells that line the small tubes ducts inside the breast, while lobular hyperplasia is an overgrowth of cell lining the milk glands lobules. The incidence of atypical hyperplasia was greatest in 6064 year old women, and was similar to the peak agespecific incidence of endometrial carcinoma. Acinic cell carcinoma is an indolent form of invasive breast cancer, whereas microglandular adenosis has been shown to be a neoplastic proliferation. Although microglandular hyperplasia is a benign endocervical lesion, it may raise concern of malignancy in an inexperienced pathologist, because clinicians may not be familiar with it on a report. The microglandular pattern is characterized by small, tightly packed round glands, lined by cuboidal to columnar cells containing abundant eosinophilic cytoplasm with round to oval nuclei, mimicking microglandular endocervical hyperplasia. Jan 27, 2011 the secs can occur as microglandular, solid syncytial or as mixture of both patterns. Therefore clinicians should choose the modality most likely to yield the best pathologic specimen.
This is suggestive of an increased estrogen state and maybe be a precursor to endometrial hyperplasia. Pdf a case of microglandular adenocarcinoma of the. 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. A contemporary approach to pathologic diagnosis of. Stolk 1 department of obstetrics and gycology and 1 department of pathology, academic hospital, vrije universiteit. Cytologic findings in microglandular hyperplasia of the cervix. Incidence of nonneoplastic cervical pathologies recorded at a medical college. Answered by a verified ob gyn doctor we use cookies. The aim of the study was to evaluate this potential association. Diagnosis and multimodal treatment of a rare tumor and analysis of worldwide experience. Cytologic atypia associated with microglandular hyperplasia cytologic atypia associated with microglandular hyperplasia valente, philip t schantz, h. How to approach the many faces of endometrioid carcinoma. If specimen is a biopsy and tumor is not clinically visible.
Microglandular adenosis microglandular adenosis mga is a rare breast lesion that is often detected incidentally and occasionally presents as a mass1. Cervix a localised proliferation of endocervical cells linked to oral contraceptive use and pregnancy. Microglandular adenocarcinoma of the uterus mimicking. 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. Microglandular hyperplasia of cervix, in pregnancy mimicking as. It is usually referred to simply as microglandular hyperplasia, abbreviated mgh, and is also known as microglandular change. Feb 29, 2012 hello, and i am pleased to help, use of my answers are for educational purposes only. Association of cervical microglandular hyperplasia with exogenous. Most patients complain of a palpable breast mass that may arouse a clinical suspicion of breast cancer. Microglandular hyperplasia of the endocervix 72480 cell. Chronic endometritis can lead to an overdiagnosis of atypical hyperplasia, especially when inflammatory cells lead to reactive nuclear. Microglandular hyperplasia of cervix is believed to form due to hormonal factors.
Genetic analysis of microglandular adenosis and acinic. Microglandular hyperplasia mgh of the uterine cervix is characterized by closely packed glands without intervening stroma, and therefore it mimics malignant glandular lesions,1, 2 especially in a curettage specimen that offers only limited overview of the lesions architecture. For many years, atypical epithelial lesions of the prostate have been known to occur, but much refining of this knowledge has evolved over the last. Endometrial hyperplasia symptoms,causes,diagnosis and.
It has an infiltrative pattern and the glands are haphazardly distributed in a hypocellular or fibrous matrix with extension into fatty stroma fig. Hyperplasia of acini results in an increase in individual acinar units but not in ducts, whereas hyperplasia of the ducts is described as an increase in ducts without a concomitant increase in acinar structures. A case of microglandular adenocarcinoma of the endometrium. Microglandular hyperplasia of the endocervix is a localized nonneoplastic proliferation of the glandular epithelium of the endocervix. The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders. Glandular adenomatous hyperplasia of the endocervix cell. Microglandular hyperplasia figure 1 is a benign endocervical lesion that should not be mistaken for adenocarcinoma. Ileallymphoidnodular hyperplasia, nonspecific colitis, and. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Although endocervical microglandular hyperplasia mgh is a common diagnosis, it can be confused with adenocarcinoma aca, mainly of the. Pdf microglandular hyperplasia of the uterine cervix.
Nov 24, 2018 significant complications from microglandular hyperplasia of cervix are generally not noted, because it is a benign condition. It is a progestogen containing device and is currently licensed for periods of treatment of five years. Although these growths may show architectural or cytological abnormalities, they differ from malignant tumours, and can easily be misinterpreted as premalignant or. Salivary gland hyperplasia nonneoplastic lesion atlas. Jun 01, 2003 read microglandular adenocarcinoma of the uterus mimicking microglandular cervical hyperplasia, annals of diagnostic pathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Rutgers university has made this article freely available. Hyperplasia of the salivary gland can be acinar, ductal figure 2, figure 4, figure 5, and figure 6, or both. General treatment decisions for adenocarcinoma of cervix. Pseudoneoplastic lesions of the female genital tract. Microglandular adenosis mga of the breast is a very rare and benign proliferative lesion. Hormone receptors in microglandular hyperplasia of the uteri. Microglandular hyperplasia of endocervix, a not so common entity is a disgnostic dilemma as it mimcs malignancy although being benign.
The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders hanna g. What is focal endocervical microglandular hyperplasia and. Objectives although microglandular hyperplasia is a benign endocervical lesion, it may raise concern of malignancy in an inexperienced pathologist, because clinicians may not be familiar with it on a report. Invasive carcinoma cells form small closed tubules and cords with surrounding desmoplastic myxoid stroma with or without a lymphocytic response. Can present as a palpable mass, usually a 3 4 cm ill defined lesion benign although has been associated with carcinoma am j surg pathol 1986. A case of florid microglandular hyperplasia of the uterine cervix that contained cells with severe atypia suggesting malignancy on a papanicolaou smear is. Jun 02, 2011 complex endometrial hyperplasia in this type of endometrial hyperplasia, there is no change in the internal makeup of the endometrial cell. Twenty cases of microglandular hyperplasia mgh of the uterine cervix and 14 cases of lowgrade nuclear mucinous adenocarcinoma of the endometrium ma were compared morphologically and immunohistochemically. Microglandular hyperplasia mgh of uterine cervix is a benign condition that occurs due to an abnormal increase of glands endocervical glands within the cervix.
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