Difference between revisions of "Cervical polyps"
Jump to navigation
Jump to search
(→Benign endocervical polyps: tweak format) |
|||
| (19 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
'''Cervical polyps''' are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign. | '''Cervical polyps''' are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign. An introduction to the ''uterine cervix'' is in the [[uterine cervix]] article. | ||
==Benign endocervical polyp== | ==Benign endocervical polyp== | ||
:''Endocervical polyp'' redirects here. | |||
===General=== | ===General=== | ||
*Usually 30-50 years old. | *Usually 30-50 years old. | ||
| Line 7: | Line 8: | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref>URL: [http://pathologyoutlines.com/cervix.html#endocervpolyp http://pathologyoutlines.com/cervix.html#endocervpolyp]. Accessed on: 22 October 2011.</ref> | ||
*May have mixed epithelium, i.e. squamous and endocervical type (with eosinophilic mucin). | *May have mixed epithelium, i.e. squamous and endocervical type (with eosinophilic mucin). | ||
**Endocervical epithelium should have nuclei like that in the colon, i.e. small, round & basal. | **Endocervical epithelium should have nuclei like that in the colon, i.e. small, round & basal. | ||
| Line 22: | Line 23: | ||
*No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp." | *No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp." | ||
DDx: | |||
*[[Benign endometrial polyp]]. | |||
*[[Fibroepithelial stromal polyp]]. | |||
*[[Adenosarcoma]]. | |||
*[[Papillary adenofibroma of the uterine cervix]].<ref name=pmid8927449>{{Cite journal | last1 = Fratini | first1 = D. | last2 = Cavaliere | first2 = A. | title = Papillary adenofibroma of the uterine cervix. A case report. | journal = Pathologica | volume = 88 | issue = 2 | pages = 135-6 | month = Apr | year = 1996 | doi = | PMID = 8927449 }}</ref> | |||
*[[Nabothian cyst]]s. | |||
====Images==== | |||
<gallery> | |||
Image: Xanthomatous endocervical polyp -- low mag.jpg | EP - low mag. | |||
Image: Xanthomatous endocervical polyp -- intermed mag.jpg | EP - intermed. mag. | |||
</gallery> | |||
===Sign out=== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP. | |||
</pre> | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION. | |||
</pre> | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH AN EROSION AND INFLAMMATION. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Significant squamous epithelium present==== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- BENIGN CERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION. | |||
</pre> | |||
====History provided==== | |||
<pre> | |||
CERVICAL POLYP, EXCISION: | |||
- BENIGN ENDOCERVICAL POLYP. | |||
</pre> | |||
==Papillary adenofibroma of the uterine cervix== | |||
*[[AKA]] ''cervical papillary adenofibroma''.<ref name=pmid16041681>{{Cite journal | last1 = Haberal | first1 = A. | last2 = Cil | first2 = AP. | last3 = Gunes | first3 = M. | last4 = Cavusoglu | first4 = D. | title = Papillary adenofibroma of the cervix: a case report. | journal = Ultrasound Obstet Gynecol | volume = 26 | issue = 2 | pages = 186-7 | month = Aug | year = 2005 | doi = 10.1002/uog.1948 | PMID = 16041681 }}</ref> | |||
===General=== | |||
*Rare.<ref name=pmid8927449>{{Cite journal | last1 = Fratini | first1 = D. | last2 = Cavaliere | first2 = A. | title = Papillary adenofibroma of the uterine cervix. A case report. | journal = Pathologica | volume = 88 | issue = 2 | pages = 135-6 | month = Apr | year = 1996 | doi = | PMID = 8927449 }}</ref> | |||
Clinical:<ref name=pmid8927449/> | |||
*[[Menorrhagia]]. | |||
===Gross=== | |||
*Polypoid mass. | |||
DDx: | |||
*[[Benign endocervical polyp]]. | |||
===Microscopic=== | |||
Features: | |||
*Branching nipple like projections (papillae) covered by endocervical epithelium +/- metaplastic squamous epithelium. | |||
*Fibrous stroma. | |||
DDx: | |||
*[[Adenosarcoma]]. | |||
==Fibroepithelial stromal polyp== | ==Fibroepithelial stromal polyp== | ||
| Line 29: | Line 92: | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid10680891/> | Features:<ref name=pmid10680891/> | ||
*Bland nuclei. | *Bland nuclei. | ||
*Hypocellular. | *Hypocellular. | ||
| Line 41: | Line 104: | ||
***Variable cellularity. | ***Variable cellularity. | ||
***Multinucleated cells. | ***Multinucleated cells. | ||
Image: | |||
*[http://www.surgpath4u.com/caseviewer.php?case_no=450 FSP (surgpath4u.com)]. | |||
==Pseudosarcomatous fibroepithelial stromal polyp== | ==Pseudosarcomatous fibroepithelial stromal polyp== | ||
| Line 57: | Line 123: | ||
*No identifiable margin between lesion and normal - important feature. | *No identifiable margin between lesion and normal - important feature. | ||
*Scattered multinucleated stromal cells - usu. close to epithelium. | *Scattered multinucleated stromal cells - usu. close to epithelium. | ||
DDx: | |||
*[[Adenosarcoma]]. | |||
===IHC=== | ===IHC=== | ||
*Desmin +ve (common). | *Desmin +ve (common). | ||
*SMA usu. -ve. | *SMA usu. -ve. | ||
==Adenosarcoma== | ==Adenosarcoma== | ||
{{Main|Adenosarcoma}} | {{Main|Adenosarcoma}} | ||
Latest revision as of 03:51, 2 February 2017
Cervical polyps are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign. An introduction to the uterine cervix is in the uterine cervix article.
Benign endocervical polyp
- Endocervical polyp redirects here.
General
- Usually 30-50 years old.
- May cause bleeding.
Microscopic
Features:[1]
- May have mixed epithelium, i.e. squamous and endocervical type (with eosinophilic mucin).
- Endocervical epithelium should have nuclei like that in the colon, i.e. small, round & basal.
- Polypoid shape.
- +/-Inflammation.
- +/-Squamous metaplasia.
Negatives:
- No mitoses.
- No nuclear atypia.
- No stromal proliferation.
Notes:
- No histologic features separate cervical polyps from benign endocervical mucosa; ergo, they are often signed-out as "... consistent with cervical polyp."
DDx:
- Benign endometrial polyp.
- Fibroepithelial stromal polyp.
- Adenosarcoma.
- Papillary adenofibroma of the uterine cervix.[2]
- Nabothian cysts.
Images
EP - low mag.
EP - intermed. mag.
Sign out
CERVICAL POLYP, EXCISION: - CONSISTENT WITH BENIGN ENDOCERVICAL POLYP.
CERVICAL POLYP, EXCISION: - CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION.
CERVICAL POLYP, EXCISION: - CONSISTENT WITH BENIGN ENDOCERVICAL POLYP WITH AN EROSION AND INFLAMMATION. - NEGATIVE FOR MALIGNANCY.
Significant squamous epithelium present
CERVICAL POLYP, EXCISION: - BENIGN CERVICAL POLYP WITH ACUTE AND CHRONIC INFLAMMATION.
History provided
CERVICAL POLYP, EXCISION: - BENIGN ENDOCERVICAL POLYP.
Papillary adenofibroma of the uterine cervix
General
- Rare.[2]
Clinical:[2]
Gross
- Polypoid mass.
DDx:
Microscopic
Features:
- Branching nipple like projections (papillae) covered by endocervical epithelium +/- metaplastic squamous epithelium.
- Fibrous stroma.
DDx:
Fibroepithelial stromal polyp
General
- Usually easy to recognize.[4]
Microscopic
Features:[4]
- Bland nuclei.
- Hypocellular.
Note:
- The Foundation series books appears to lump together fibroepithelial stromal polyp and pseudosarcomatous fibroepithelial stromal polyp.
- Features as per Foundation series book:[5]
- Polypoid lesions.
- Squamous epithelium.
- Variable cellularity.
- Multinucleated cells.
- Features as per Foundation series book:[5]
Image:
Pseudosarcomatous fibroepithelial stromal polyp
General
- Uncommon.
- Wide age range.
- May be misdiagnosed as a sarcoma and overtreated.[4]
- Similar lesions in vagina and vulva.
Microscopic
Features:[4]
- Hypercellularity.
- Marked nuclear pleomorphism (common).
- +/-High mitotic rate ( > 10 mitoses / 10 HPF).
- +/-Atypical mitoses.
- No identifiable margin between lesion and normal - important feature.
- Scattered multinucleated stromal cells - usu. close to epithelium.
DDx:
IHC
- Desmin +ve (common).
- SMA usu. -ve.
Adenosarcoma
Main article: Adenosarcoma
See also
References
- ↑ URL: http://pathologyoutlines.com/cervix.html#endocervpolyp. Accessed on: 22 October 2011.
- ↑ 2.0 2.1 2.2 Fratini, D.; Cavaliere, A. (Apr 1996). "Papillary adenofibroma of the uterine cervix. A case report.". Pathologica 88 (2): 135-6. PMID 8927449.
- ↑ Haberal, A.; Cil, AP.; Gunes, M.; Cavusoglu, D. (Aug 2005). "Papillary adenofibroma of the cervix: a case report.". Ultrasound Obstet Gynecol 26 (2): 186-7. doi:10.1002/uog.1948. PMID 16041681.
- ↑ 4.0 4.1 4.2 4.3 Nucci, MR.; Young, RH.; Fletcher, CD. (Feb 2000). "Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma.". Am J Surg Pathol 24 (2): 231-40. PMID 10680891.
- ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 31. ISBN 978-0443069208.