The Spectrum of Cervical Glandular Neoplasia and Issues in Differential Diagnosis

Loureiro, Joana; Oliva, Esther

doi:10.5858/arpa.2012-0493-ra

Cited by 62 publications

(44 citation statements)

References 285 publications

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“…It is well recognised that the distinction of endocervical and endometrial carcinoma can be problematic even on biopsy material, sometimes necessitating additional immunohistological studies for resolution. 17 We found that the risk of high-grade cervical dysplasia was greater in younger women (aged 25-34 years), and in those with no cervical screening history or a previously detected low-grade cytological abnormality. In contrast, there was no correlation with socio-economic status or with access to services.…”

Section: Discussionmentioning

confidence: 68%

Risk of high‐grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state‐wide screening population in Western Australia

Munro¹,

Williams

Semmens

et al. 2015

Aust NZ J Obst Gynaeco

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Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-toevent analysis was used to predict the odds of having or developing in situ and invasive neoplasia. Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.

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Section: Discussionmentioning

confidence: 68%

Risk of high‐grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state‐wide screening population in Western Australia

Munro¹,

Williams

Semmens

et al. 2015

Aust NZ J Obst Gynaeco

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“…2A, C) may raise the possibility of an invasive ENDO-CA or EM-CA. [26][27][28] In contrast, some EM-CAs may invade the cervical stroma and undermine normal endocervical glands with little in the way of a stromal response, closely mimicking MRs or MHs. 29 Rarely, MCAs may arise as primary neoplasms in the wall of the uterine corpus (2 cases included in this study; Fig.…”

Section: Discussionmentioning

confidence: 99%

GATA3 Is a Sensitive and Specific Marker of Benign and Malignant Mesonephric Lesions in the Lower Female Genital Tract

Howitt

Emori

Drapkin

et al. 2015

American Journal of Surgical Pathology

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130

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GATA3 is a transcription factor critical for embryogenesis, development, and cell differentiation. Recent studies have suggested that GATA3 is a sensitive and relatively specific biomarker for urothelial and breast carcinomas, with most Müllerian carcinomas being negative. We investigated GATA3 expression in mesonephric/Wolffian remnants and tumors in the female genital tract. A western blot was performed to assess specificity for the GATA3 antibody. GATA3 immunohistochemistry was performed on 59 formalin-fixed paraffin-embedded mesonephric samples, including 17 mesonephric remnants (MR; 11 cervical and 6 fallopian tube), 15 mesonephric hyperplasias, 21 mesonephric carcinomas, and 6 female adnexal tumors of probable Wolffian origin. Thirty conventional endocervical adenocarcinomas (ENDO-CA), 9 gastric-type cervical adenocarcinomas, and 165 endometrial adenocarcinomas (EM-CA) were also evaluated. GATA3 nuclear intensity and extent of staining was evaluated. The western blot revealed GATA3 expression in seminal vesicle and cell lines derived from breast and urothelial carcinomas, but not in other cell lines including ovarian, cervical, and endometrial cancers. All cervical MRs and mesonephric hyperplasias, 5/6 (83%) fallopian tube MRs, and 20/21 (95%) mesonephric carcinomas were GATA3 positive, although with great variability in both intensity (weak to strong) and extent (1+ to 3+) of staining. Only 1/6 (17%) female adnexal tumors of probable Wolffian origin showed weak multifocal staining. One of 30 (3%) usual-type ENDO-CAs and 3/165 EM-CAs exhibited weak-moderate GATA3 immunoreactivity; all gastric-type cervical adenocarcinomas were negative. GATA3 is a highly sensitive and specific marker for mesonephric lesions in the lower genital tract; however, its utility in the upper genital tract may be more limited. In addition, GATA3 can aid in distinguishing lower genital mesonephric lesions from usual-type and gastric-type ENDO-CAs and uterine EM-CAs.

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“…Microglandular hyperplasia of the endocervix is a localized non-neoplastic proliferation of the glandular epithelium of the endocervix. Although these growths may show architectural or cytological abnormalities, they differ from malignant tumours, and can easily be misinterpreted as pre-malignant or malignant neoplasms of the endocervix [9][10][11]. Microglandular hyperplasia is found most commonly in younger women (between the ages of 25-37) and is often an incidental microscopic finding [12,13], is just like adenocarcinoma of the endometrium, associated with endogenous hormones, and induced by pregnancy hormones, gynecological therapeutic treatments or through oral contraceptive therapy [6,7,14].…”

Section: Discussionmentioning

confidence: 99%

Florid Endocervical Microglandular Hyperplasia in Association with Tamoxifen Treatment

Ayakannu¹,

Wsr²

2015

J Cytol Histol

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The Spectrum of Cervical Glandular Neoplasia and Issues in Differential Diagnosis

Cited by 62 publications

References 285 publications

Risk of high‐grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state‐wide screening population in Western Australia

Risk of high‐grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state‐wide screening population in Western Australia

GATA3 Is a Sensitive and Specific Marker of Benign and Malignant Mesonephric Lesions in the Lower Female Genital Tract

Florid Endocervical Microglandular Hyperplasia in Association with Tamoxifen Treatment

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