Tubal metaplasia of the uterine cervix

K S Suh, Suh KS, S G Silverberg, Silverberg SG
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1990 · doi:10.1097/00004347-199004000-00003 · PMID:2332270
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This case series of eleven patients describes tubal metaplasia of the uterine cervix, noting its concurrent identification with endometriosis and emphasizing that recognizing this benign lesion prevents confusion with early endocervical glandular neoplasia.

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This case series describes the histological features of tubal metaplasia in the uterine cervix, noting that affected glands contain ciliated or clear cells resembling normal tubal mucosa. The study found no correlation between the presence of this metaplastic change and cervical inflammation or squamous metaplasia, while also observing concurrent benign lesions such as endometriosis in some specimens. The authors emphasize that recognizing this condition is primarily important to prevent misdiagnosis as early endocervical glandular neoplasia. Relevance to endometriosis: endometriosis is listed as one of several benign glandular lesions concurrently identified in patients with tubal metaplasia, though the paper's main focus is the characterization of the metaplastic lesion itself.

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Abstract

Eleven cases of tubal metaplasia of the uterine cervix are presented. These are characterized histologically by architecturally normal endocervical glands containing ciliated or clear cells, nonciliated cells, and intercalary or peg cells, resembling normal tubal mucosa. Transitions from normal to ciliated epithelium within a single gland are frequently seen. Eight of these cases involved endocervical glands near the squamocolumnar junction, and six showed tubal metaplasia along the overlying surface epithelium. Superficial and (in one case) deep endocervical glands were involved. No correlation was found between the presence of tubal metaplasia and the degree of inflammation of the cervix or the presence or extent of squamous metaplasia. Immunohistochemically, the epithelium of tubal metaplasia was negative for carcinoembryonic antigen in five cases studied. In situ squamous carcinoma and a variety of benign glandular lesions, such as microglandular hyperplasia, mesonephric remnants, and endometriosis, were concurrently identified. Two cases also accompanied tubal metaplasia in proliferative and hyperplastic endometria, and tubal metaplasia was seen in the lower uterine segment in five cases. We emphasize that, as with other types of metaplasia, the main significance of recognizing this lesion in the cervix is in not confusing it with early endocervical glandular neoplasia.
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Tubal Metaplasia of the Uterine Cervix - Kwang-Sun Suh - Steven G. Silverberg Summary: Eleven cases of tubal metaplasia of the uterine cervix are presented. These are characterized histologically by architecturally normal endocervical glands containing ciliated or clear cells, nonciliated cells, and intercalary or peg cells, resembling normal tubal mucosa. Transitions from normal to ciliated epithelium within a single gland are frequently seen. Eight of these cases involved endocervical glands near the squamocolumnar junction, and six showed tubal metaplasia along the overlying surface epithelium. Superficial and (in one case) deep endocervical glands were involved. No correlation was found between the presence of tubal metaplasia and the degree of inflammation of the cervix or the presence or extent of squamous metaplasia. Immunohistochemically, the epithelium of tubal metaplasia was negative for carcinoembryonic antigen in five cases studied. In situ squamous carcinoma and a variety of benign glandular lesions, such as microglandular hyperplasia, mesonephric remnants, and endometriosis, were concurrently identified. Two cases also accompanied tubal metaplasia in proliferative and hyperplastic endometria, and tubal metaplasia was seen in the lower uterine segment in five cases. We emphasize that, as with other types of metaplasia, the main significance of recognizing this lesion in the cervix is in not confusing it with early endocervical glandular neoplasia.

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Condition tags

endometriosis

MeSH descriptors

Cervix Uteri Adult Cervix Uteri Diagnosis, Differential Female Humans Metaplasia Metaplasia Middle Aged

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europepmc
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pubmed
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