Clinicopathological characteristics of cervical atypical microglandular hyperplasia:a misdiagnosis analysis of 7 cases

LUO Bin; YUAN Jing-ping; ZHAO Li-na; ZHANG Xiu-yun; CHEN Li-xia

doi:10.3969/j.issn.1007-8096.2023.08.001

Abstract：Objective To analyze the clinicopathological characteristics,differential diagnosis and causes of misdiagnosis of cervical atypical microglandular hyperplasia(MGH),so as to improve the diagnosis rate of the disease and prognosis of patients.Methods The histopathological features and immunophenotypes of 7 patients with atypical MGH were analyzed retrospectively,and the related literatures were reviewed and discussed.Results There were 7 females with an average age of 35.5 years(26-43 years).7 patients were treated in local hospitals due to irregular vaginal discharge and bleeding.All of the 7 patients underwent cervical biopsy and pathological examination,of which 4 patients were misdiagnosed as cervical adenocarcinoma by the pathologist of the local hospital.Subsequently,they came to our hospital for pathological consultation.Microscopically,7 cases of lesions were all composed of multiple gland cavities with different sizes and densely clustered arrangement.The structure of some glands were sieve.The cytoplasm was eosinophilic.Intracellular or extracellular vacuoles were visible.The cells were slightly atypical,and mitotic figures were visible,accompanied by extensive immature squamous metaplasia.Immunohistochemistry showed that scattered cells were positive for P16,CEA was focally positive,individual cells were positive for P53,ER was positive,and Ki-67 showed low proliferation.Conclusion Cervical microglandular hyperplasia is a benign proliferative disease,which is easily confused with cervical adenocarcinoma and relevant malignant tumors when it is atypical.It needs clinical and pathological doctors to improve their understanding of the disease.Its pathological diagnosis mainly depends on histological morphology and immunohistochemical staining,so as to prevent misdiagnosis.