Lobular endocervical glandular hyperplasia is a metaplastic process with a pyloric gland phenotype
Lobular endocervical glandular hyperplasia is a metaplastic process with a pyloric gland phenotype
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DOI：
10.1046/j.1365-2559.2001.01239.x
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发表时间：
2001-10-01
期刊：
影响因子：
6.4
通讯作者：
Manabe, T
中科院分区：
文献类型：
--
作者：
Mikami, Y;Hata, S;Manabe, T
目的：小叶性宫颈内腺体增生症是一种罕见的宫颈假性肿瘤性病变。最近描述的。目的：分析小叶颈腺增生症的临床病理和免疫组织化学特点，明确其幽门腺体表型，并与宫颈恶性腺瘤相鉴别。方法：对9例小叶性颈腺增生症进行组织学和免疫组织化学研究。9例患者年龄38~，平均48.8岁。意外发现6例。而在三个病例中，阴道分泌物和影像检查显示，术前腺瘤是恶性的。光镜下，小叶性颈腺体增生症最大平面范围为1~20朗姆(平均6.8 mm)，最大深度为1~10 mm(平均3.9 mm)。以小腺体小叶排列为特征，由低柱状细胞组成，胞浆苍白，胞核淡淡。3例为假性侵袭性生长。胞浆内粘蛋白主要为PAS阳性，7例显示M-CGMC-1免疫反应，M-CGMC-1是一种与幽门腺型粘蛋白反应的抗体。仅见灶性微弱的CEA反应，ER均为阴性。在所有病例中，细胞角蛋白图谱均为CK7+/20-，这与它们的米勒起源一致。三种病变均含有嗜铬粒细胞阳性的内分泌细胞，术后均无复发，平均随访48.4个月。结论：小叶颈腺增生症是一种形态明显的假性肿瘤性腺病，具有幽门腺所特有的表型特征。虽然大多数是偶然发现的，但一些病例可能表现出类似于恶性腺瘤的临床和放射学特征。
Aims: Lobular endocervical glandular hyperplasia of the uterine cervix is a rare pseudoneoplastic lesion of the uterine cervix. described recently. Our aim was to characterize the clinicopathological and immunohistochemical features of lobular endocervical glandular hyperplasia, to elucidate its pyloric gland phenotype, and to distinguish it from adenoma malignum of the uterine cervix.Methods and results: Nine cases of lobular endocervical glandular hyperplasia were studied histologically and immunohistochemically. The average age of the nine patients was 48.8 years (range 38-64 years). Six cases were found incidentally. whereas in three cases a watery vaginal discharge and imaging studies suggested adenoma malignum preoperatively. Microscopically, lobular endocervical glandular hyperplasia ranged from 1 mm to 20 rum (mean 6.8 mm) in the largest horizontal extent and 1 mm to 10 mm (mean 3.9 mm) in depth. and was characterized by lobular arrangements of small glands composed of low columnar cells with pale eosinophilic cytoplasm and bland nuclei. Three cases showed a pseudo-invasive growth. Intracytoplasmic mucin was predominantly PAS-positive, and seven cases showed immunoreactivity for M-CGMC-1, an antibody that reacts with pyloric gland-type mucin. Only focal and faint reactivity for CEA was seen, and ER was negative in all cases. The cytokeratin profile was CK7+/20- in all cases, in keeping with their Mullerian derivation. All three lesions examined contained chromogranin-positive endocrine cells, After surgery all patients are well without recurrent disease (mean follow-up was 48.4 months).Conclusions: Lobular endocervical glandular hyperplasia is a morphologically distinct pseudoneoplastic glandular lesion, which has unique phenotypic characteristics shared by pyloric glands of the stomach. Although most are found incidentally, some cases may show clinical and radiological features resembling those of adenoma malignum.