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Cytologic atypia associated with microglandular hyperplasia
P T Valente1, H D Schantz, M Schultz
1Department of Pathology, University of Texas Health Science Center at San Antonio 78284-7750.
Diagnostic Cytopathology
|January 1, 1994
Summary
Microglandular hyperplasia (MGH) in cervical smears can mimic serious conditions like adenocarcinoma and high-grade squamous intraepithelial lesions (HGSIL). Recognizing MGH cytomorphology is crucial to avoid misdiagnosis and unnecessary procedures.
Area of Science:
- Cytopathology
- Gynecologic Pathology
- Cervical Screening
Background:
- Microglandular hyperplasia (MGH) is a benign cervical condition.
- MGH can present with cytologic atypia in cervical smears.
- Detailed cytomorphology of MGH is not well-established.
Purpose of the Study:
- To describe the cytomorphology of microglandular hyperplasia (MGH).
- To assess the potential for MGH to mimic neoplastic glandular and squamous lesions in cervical cytology.
Main Methods:
- Review of Pap smears from biopsy-proven MGH cases over a 3-year period.
- Analysis of 122 smears containing endocervical cells.
- Comparison of cytologic findings with biopsy and conization results.
Main Results:
- 34% of MGH cases showed striking glandular abnormalities.
- MGH was misdiagnosed as adenocarcinoma/adenocarcinoma in situ in two cases.
- MGH-related atypia led to overcalls of high-grade squamous intraepithelial lesion (HGSIL) in five out of six unconfirmed HGSIL diagnoses.
Conclusions:
- Cytologic features of MGH can mimic glandular neoplasia and HGSIL.
- Awareness of MGH cytomorphology is essential for accurate cervical smear interpretation.
- MGH-induced atypia, while striking, is not entirely specific and differs from true neoplastic changes.