Cervical polyps

Cervical polyps are common entities that can be bothersome and are thus removed by a gynecologist. The vast majority are benign.

Benign endocervical polyps

Clinical

• Usually 30-50 years old.
• Cause bleeding - due to trauma (???).

Microscopic

Features:

• 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."

Ref.:

Fibroepithelial stromal polyp

General

• Usually easy to recognize.

Microscopic

Features: (???)

• 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:
    • Polypoid lesions.
    • Squamous epithelium.
    • Variable cellularity.
    • Multinucleated cells.

Pseudosarcomatous fibroepithelial stromal polyp

General

• Uncommon.
• Wide age range.
• May be misdiagnosed as a sarcoma and overtreated.
• Similar lesions in vagina and vulva.

Microscopic

Features:

• 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.

IHC

• Desmin +ve (common).
• SMA usu. -ve.

Adenosarcoma

Main article: Adenosarcoma

See also

• Cervix.
• Endometrial polyp.
• Gynecologic pathology.