Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Ohya, Ayumi; Asaka, Shiho; Fujinaga, Yasunari; Kadoya, Masumi

doi:10.1111/jog.13528

Cited by 10 publications

(7 citation statements)

References 13 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Detecting a cervical cystic lesion on sonography often leads to diagnosis of LEGH. The MR images of the multicystic lesion typically show a large number of small cysts surrounded by many larger cysts, which is called a “cosmos sign” [23,28,29]. The present study revealed that shape and size of the lesion depended on menopausal status and age.…”

Section: Discussionmentioning

confidence: 51%

Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia

Omori¹,

Kondo²,

Tagaya³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

Objectives To investigate the use of imaging methods for predicting carcinogenesis in lobular endocervical glandular hyperplasia (LEGH). Methods We retrospectively analyzed preoperative images on transvaginal sonography and magnetic resonance imaging (MRI) in 23 cases with histologically diagnosed LEGH. Results Shape of cervical multicystic lesions on MR images could be divided into two types the flower-type with many small cysts surrounded by larger cysts, and the raspberry-type with many tiny, closely aggregated cysts. Six (46%) of 13 cases had raspberry-type lesions that were not detected on transvaginal sonography but were seen on MRI. Adenocarcinoma in situ (AIS) was identified in 4 postmenopausal women with raspberry-type lesions during the follow-up periods. In these cases, cytologic examination by targeted endocervical sampling using sonography enabled early detection of AIS. Conclusions MRI and cytologic examination by targeted endocervical sampling may be very useful for predicting carcinogenesis in LEGH.

show abstract

Section: Discussionmentioning

confidence: 51%

Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia

Omori¹,

Kondo²,

Tagaya³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…In contrast, a study reported that diffusion restriction is important in the diagnosis of malignant tumors, 17 and another reported that malignant tumors associated with lobular endocervical glandular hyperplasia exhibited diffusion restriction. 15 In the present study, we could not deny the possibility of malignancy because of the presence of diffusion restriction. Further research is needed to evaluate the diagnostic potential of MRI in the detection of malignancy, especially those cases containing abundant mucin.…”

Section: Discussionmentioning

confidence: 55%

“…However, these patients were diagnosed with lobular endocervical glandular hyperplasia and not cancer. Previous studies reported that no diffusion restriction was observed in malignant tumors associated with lobular endocervical glandular hyperplasia, 15 16 possibly due to the low cell density and low viscosity of intra-tumor mucins. In contrast, a study reported that diffusion restriction is important in the diagnosis of malignant tumors, 17 and another reported that malignant tumors associated with lobular endocervical glandular hyperplasia exhibited diffusion restriction.…”

Section: Discussionmentioning

confidence: 82%

Limited frequency of malignant change in lobular endocervical glandular hyperplasia

Kobara¹,

Miyamoto²,

Ando³

et al. 2020

Int J Gynecol Cancer

Self Cite

View full text Add to dashboard Cite

IntroductionAlthough lobular endocervical glandular hyperplasia is a benign disorder of the uterine cervix, its potential as a precursor of minimal deviation adenocarcinoma has been reported. However, the natural history of the disease and the frequency of malignant change are not fully understood. We evaluated the frequency of malignant change of clinical lobular endocervical glandular hyperplasia and explored useful parameters indicating malignant change.MethodsThe clinical courses of 175 patients with cervical multi-cystic lesions who visited Shinshu University Hospital between June 1995 and June 2019 were retrospectively analyzed. We examined the results of follow-up and outcomes of the patients diagnosed with lobular endocervical glandular hyperplasia and investigated the frequency of malignant transformation.ResultsOf the 175 patients, 15, 84, and 76 were clinically diagnosed with suspected malignancy, suspected lobular endocervical glandular hyperplasia, and suspected nabothian cyst, respectively. Of these patients, 69 patients with suspected lobular endocervical glandular hyperplasia were followed, and 12 underwent hysterectomy after a mean follow-up of 57.1 (range: 3–154) months due to lesion enlargement (increase in tumor diameter of >20%) and/or worsening cytology. Of these 12 patients, two had lobular endocervical glandular hyperplasia with atypia and one had minimal deviation adenocarcinoma. Of 69 patients, the rate of malignant change was 1.4% (1/69). The growth rates of the lesions for these three patients during follow-up were significantly higher than those of nine patients who underwent surgery with lobular endocervical glandular hyperplasia without atypia and 48 follow-up cases of suspected lobular endocervical glandular hyperplasia. The cut-off value of the growth rate suggesting malignant transformation was 38.1% (84.6% sensitivity and 100% specificity). Tumor size and cytology did not change in the remaining 57 cases continuing follow-up.ConclusionAn increase in tumor size and worsening cytology are important parameters for detecting malignant transformation of lobular endocervical glandular hyperplasia during follow-up. However, the frequency of malignant change of this disease may be limited. These results suggest that conservative management may be an option for clinical lobular endocervical glandular hyperplasia.

show abstract

“…Recent studies have revealed a relationship between LEGH and gastric‐type mucinous carcinomas. Some reports have described adenocarcinomas in association with LEGH 9–12 . Therefore, LEGH may be a precursor lesion for adenocarcinomas, especially gastric‐type mucinous carcinomas 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of the ‘cosmos pattern’ for differentiating between cervical gastric‐type mucin‐positive lesions and other benign cervical cystic lesions in magnetic resonance images

Ohya

Kobara

Miyamoto

et al. 2020

J of Obstet and Gynaecol

Self Cite

View full text Add to dashboard Cite

Aim: To evaluate the usefulness of the 'cosmos pattern' (CP) on magnetic resonance (MR) images for differentiating between gastric-type mucin-positive lesions (GMPL) and gastric-type mucin-negative lesions (GMNL). Methods: This study included 131 patients with clinical suspicion of lobular endocervical glandular hyperplasia (LEGH) who underwent pelvic MR imaging and a Pap smear and/or latex agglutination assay. Differences in MR findings, such as cyst and solid component patterns, cervical location and T1-weighted image (T1WI) signal intensity, were compared between GMPL and GMNL. The diagnostic performances of the findings were assessed. Results: The frequencies of CP (63.1%), upper part (UP) lesions (72.3%) and hypointense area compared with the cervical stroma on T1WI (61.3%) were significantly greater in GMPL than in GMNL (P < 0.05). The sensitivity, specificity, positive predictive value, negative predictive value and odds ratio of the CP for diagnosis of GMPL were 63.1%, 87.9%, 83.7%, 70.7% and 12.4, respectively. In GMNL, a 'macrocystic pattern' was observed in 65.2% of patients; an isointense or hyperintense area on T1WI was observed in 86.4% of patients. The sensitivity was highest (90.8%) when one or more of the following were observed: CP, UP lesion, or hypointense area on T1WI. The specificity was highest (95.5%) when the CP was observed as a hypointense area on T1WI. Conclusion: The CP is a highly specific finding for diagnosis of GMPL. If the CP is observed as a hypointense area compared with the cervical stroma on T1WI, GMPL (i.e., LEGH or gastric-type mucinous carcinoma) should be strongly suspected.

show abstract

Uterine cervical adenocarcinoma associated with lobular endocervical glandular hyperplasia: Radiologic–pathologic correlation

Abstract: On MR imaging, the most common type of adenocarcinoma with LEGH is type A; type C is difficult to diagnose as carcinoma.

Cited by 10 publications

References 13 publications

Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia

Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia

Limited frequency of malignant change in lobular endocervical glandular hyperplasia

Usefulness of the ‘cosmos pattern’ for differentiating between cervical gastric‐type mucin‐positive lesions and other benign cervical cystic lesions in magnetic resonance images

Contact Info

Product

Resources

About