Subnuclear vacuoles were seen in 10 cases of mgh but were absent in all ma. Pathology outlines microglandular adenosis of breast. The treatment measures for microglandular hyperplasia of uterine cervix may include the following. 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. All available cases of mgh in our 1990 surgical pathology files were. Pdf although endocervical microglandular hyperplasia mgh is a common diagnosis, it can be confused with adenocarcinoma aca. Microglandular adenosis mga of the breast is a very rare and benign proliferative lesion.
A clinicopathologic study of 11 cases with ultrastructural observations. Microglandular adenosis of the breast surgical pathology. 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. This is suggestive of an increased estrogen state and maybe be a precursor to endometrial hyperplasia.
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. 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. Cervix a localised proliferation of endocervical cells linked to oral contraceptive use and pregnancy. Although these growths may show architectural or cytological abnormalities, they differ from malignant tumours, and can easily be misinterpreted as premalignant or. Atypical endometrial hyperplasia this may also be simple or complex. Cervical microglandular hyperplasia new doctor insights. Microglandular hyperplasia definition of microglandular. The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders hanna g. The utility of immunohistochemistry in the differential. It is usually referred to simply as microglandular hyperplasia, abbreviated mgh, and is also known as microglandular change. Microglandular hyperplasia a complicating factor in the.
Cytologic atypia associated with microglandular hyperplasia cytologic atypia associated with microglandular hyperplasia valente, philip t schantz, h. Microglandular hyperplasia figure 1 is a benign endocervical lesion that should not be mistaken for adenocarcinoma. Pdf a case of microglandular adenocarcinoma of the. Benign prostatic hyperplasia bph is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone.
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. 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. 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. Findings from 25 additional smears from patients with microglandular hyperplasia are reported. Although pure mghlike uterine carcinomas are rare 25, a focal microglandular pattern in endometrial endometrioid adenocarcinomas is quite frequent. It is of no major clinical significance, but clinicians may not be familiar with it.
The endometrial glands are crowded and separated by relatively scanty stroma, without a and b or with c and d signi. Cytologic atypia associated with microglandular hyperplasia. Hyperplasia of the salivary gland can be acinar, ductal figure 2, figure 4, figure 5, and figure 6, or both. Microglandular adenosis microglandular adenosis mga is a rare breast lesion that is often detected incidentally and occasionally presents as a mass1. 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.
Atypical adenomatous hyperplasia adenosis of the prostate. Carcinoma, in situ and invasive, has been reported in association with microglandular adenosis reported in up to 27%. It has an infiltrative pattern and the glands are haphazardly distributed in a hypocellular or. 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. Earlier, it seemed that mgh could be confused with malignancy, but that the malignancy can. 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. Apparently disproportionate numbers of metaplastic, adenoid cystic and basallike carcinomas. 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.
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. Microglandular hyperplasia of uterine cervix dovemed. Jun 02, 2011 complex endometrial hyperplasia in this type of endometrial hyperplasia, there is no change in the internal makeup of the endometrial cell. Genetic analysis of microglandular adenosis and acinic. To our best knowledge, this is the twelfth case of uterine carcinoma simulating microglandular hyperplasia in the literature. Microglandular hyperplasia of the uterine cervix libre. 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. How is microglandular hyperplasia of uterine cervix treated. Cytologic findings in microglandular hyperplasia of the. Printable microglandular adenosis of the breast surgical. Transitional atypical microglandular adenosis has been proposed increased irregularity and density of glands. Salivary gland hyperplasia nonneoplastic lesion atlas.
A report of six cases microglandular endocervical hyperplasia atypical microglandular hyperplasia. What is focal endocervical microglandular hyperplasia and what does it mean. 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. Postmenopausal women on tamoxifen who are diagnosed with endometrial hyperplasia, even without. Pax2 and cyclin d1 expression in the distinction between cervical microglandular hyperplasia and endometrial microglandular like carcinoma.
Microglandular hyperplasia of cervix, in pregnancy mimicking as. Microglandular hyperplasia is a reactive process of. Microglandular hyperplasia of the endocervix 72480 cell. Microglandular hyperplasia mgh of uterine cervix is a benign condition that occurs due to an abnormal increase of glands endocervical glands within the cervix. Cone procedure, regardless of ais, early or deep invasion if specimen is a biopsy and tumor is clinically visible. It is mostly diagnosed in young adult women or during pregnancy.
A contemporary approach to pathologic diagnosis of. Association of cervical microglandular hyperplasia with exogenous progestin exposure. Acinic cell carcinoma is an indolent form of invasive breast cancer, whereas microglandular adenosis has been shown to be a neoplastic proliferation. It has an infiltrative pattern and the glands are haphazardly distributed in a hypocellular or fibrous matrix with extension into fatty stroma fig. Incidence of nonneoplastic cervical pathologies recorded at a medical college. Ho f c yt o log i a l st u r n olg journal of cytology. 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.
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. 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. The effects of the levonorgestrel intrauterine system. 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. It is a progestogen containing device and is currently licensed for periods of treatment of five years. Pdf to identify cytomorphologic features specific to microglandular hyperplasia mgh in cervical cytologic smears. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Cytologic findings in microglandular hyperplasia of the cervix. The incidence of atypical hyperplasia was greatest in 6064 year old women, and was similar to the peak agespecific incidence of endometrial carcinoma.
The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders. Ductal and lobular hyperplasia occur at about the same rate, and have about the same effect on breast cancer risk. The aim of the study was to evaluate this potential association. Nov 24, 2018 significant complications from microglandular hyperplasia of cervix are generally not noted, because it is a benign condition. It warrants follow up with periodic re biopsy yo make sure nothing else is. The cells of microglandular hyperplasia show less nuclear atypia, they have a low proliferation index mib1 and their cytoplasm contains mucin, not glycogen. Most patients complain of a palpable breast mass that may arouse a clinical suspicion of breast cancer.
Microglandular hyperplasia of the endocervix is a localized nonneoplastic proliferation of the glandular epithelium of the endocervix. Eusebi v, foschini mp, betts cm, gherardi g, millis rr, bussolati g, azzopardi jg. Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and. Microglandular adenosis of the breast radiology reference. Endocervical curettage is recommended at the time of excisional biopsy in suspected glandular abnormalities. Diagnosis and multimodal treatment of a rare tumor and analysis of worldwide experience. Pseudoneoplastic lesions of the female genital tract. Treatment of glandular lesions an intact specimen with interpretable margins is key to direct therapy in glandular abnormalities. Association of cervical microglandular hyperplasia with exogenous. Rutgers university has made this article freely available. In contrast to invasive adenocarcinoma, microglandular hyperplasia reacts negatively for cea and for p16ink4a. If specimen is a biopsy and tumor is not clinically visible. Media in category histopathology of the female reproductive system the following 160 files are in this category, out of 160 total.
Microglandular hyperplasia of the endocervix may possibly be confused with endocervical adenocarcinoma. Microglandular adenosis mga of the breast is a pathological subtype of mammary adenosis. It has been reported to occur in association with progestational stimulation, but this has not been well studied. Incidence of nonneoplastic cervical pathologies recorded. It is benign breast condition although can mimic a breast cancer particularly tubular breast carcinoma 3,5 both clinically, radiology and pathologically. Mgh, microglandular hyperplasia the mirena coil is a levonorgestrel releasing intrauterine device that is in widespread use in the uk and elsewhere. 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. Indication of microglandular hyperplasia on a pathology report may raise. A case of florid microglandular hyperplasia of the uterine cervix that contained cells with severe atypia suggesting malignancy on a papanicolaou smear is.
Hormone receptors in microglandular hyperplasia of the uteri. Chronic endometritis can lead to an overdiagnosis of atypical hyperplasia, especially when inflammatory cells lead to reactive nuclear. The following case points out the clinical and patho logical dilemma, which may arise in the appropriate management of this type of lesion. It is considered the only benign breast lesion that lacks a myoepithelial layer 4. Stolk 1 department of obstetrics and gycology and 1 department of pathology, academic hospital, vrije universiteit. Although endocervical microglandular hyperplasia mgh is a common diagnosis, it can be confused with adenocarcinoma aca, mainly of the. Microglandular adenocarcinoma of the uterus mimicking. 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. Answered by a verified ob gyn doctor we use cookies. Glandular adenomatous hyperplasia of the endocervix cell. Uterine carcinomas simulating microglandular hyperplasia. Jan 27, 2011 the secs can occur as microglandular, solid syncytial or as mixture of both patterns. Feb 29, 2012 hello, and i am pleased to help, use of my answers are for educational purposes only.
Therefore clinicians should choose the modality most likely to yield the best pathologic specimen. Endometrial hyperplasia symptoms,causes,diagnosis and. Pathology of endometrial hyperplasia and carcinoma obgyn key. Association of cervical microglandular hyperplasia with. What is focal endocervical microglandular hyperplasia and. Microglandular hyperplasia in cervical cone biopsies taken for. A case of microglandular adenocarcinoma of the endometrium. Microglandular endocervical hyperplasia definition of. Ileallymphoidnodular hyperplasia, nonspecific colitis, and.
Microglandular adenosis, apocrine adenosis, and tubular carcinoma of the breast. 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. Association of cervical microglandular hyperplasia with exogenous progestin exposure debra heller, md, lena nguyen md, laura t. 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. 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. Pdf microglandular hyperplasia of the uterine cervix. Microglandular hyperplasia mgh of the cervix is an epithelial endocervical mucosa benign abnormality lesion associated with gland proliferation.
Because microglandular adenocarcinoma can be confused with benign lesions like microglandular hyperplasia and malignant. Invasive carcinoma cells form small closed tubules and cords with surrounding desmoplastic myxoid stroma with or without a lymphocytic response. Cytologic diagnosis in cervical smears article pdf available in acta cytologica 432. Breast nonmalignant microglandular adenosis of breast. Surface epithelial changes in uterine endometrioid. But there is a proliferation at the point where the normal structure of the endometrium is interfered. 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. General treatment decisions for adenocarcinoma of cervix. 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. 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, atypical epithelial lesions of the prostate have been known to occur, but much refining of this knowledge has evolved over the last.
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