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Distribution of cervical glandular intraepithelial neoplasia: are hysterectomy specimens sampled appropriately?
1Department of Pathology, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. markkheatley@hotmail.com
Aims:
To establish the validity of assuming that by examining midline blocks from the anterior and posterior lips of the cervix, a previously unsuspected cervical intraepithelial glandular neoplasia (CIGN) lesion would be identified.
Methods:
The distribution of CIGN in 30 cone biopsy specimens of cervix was examined.
Results:
Nine low grade and 21 high grade cases were identified involving one or other lip in 29 patients and one or both lateral edges in 20. The distribution of CIGN was unifocal in 20 patients, involved two distinct foci in nine, and three distinct foci in one. Only three patients had a circumferential distribution. Midline disease, either CIGN or squamous cervical intraepithelial neoplasia (CIN), or both, was present in 27 patients.
Conclusion:
These findings suggest that examining the midline blocks from hysterectomy specimens will result in the identification of CIGN lesions in over 90% of patients, either because the CIGN lesion is present in the midline or because an associated squamous CIN lesion will be identified, which will result in the examination of the entire cervix, with the consequent identification of the CIGN lesion.
