Superficial Endometriosis of the Uterine Cervix

Baker PM, Patricia M Baker, P M Baker, P B Clement, Clement PB, Philip B. Clement, D A Bell, Bell DA, Debra A. Bell, Young RH, R H Young, Robert H. Young
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1999 · vol. 18(3) , pp. 198–205 · doi:10.1097/00004347-199907000-00002 · PMID:12090586 · W2043398153
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

This study describes twenty cases of superficial cervical endometriosis, often mistaken for glandular dysplasia or adenocarcinoma, emphasizing characteristic microscopic findings that aid correct diagnosis.

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This report describes twenty cases of superficial endometriosis in the uterine cervix, noting that these lesions are frequently incidental microscopic findings. The primary diagnostic challenge arises because the presence of mitotic figures and obscured stromal cells due to inflammation or hemorrhage often leads clinicians to suspect endocervical glandular dysplasia or adenocarcinoma in situ. Key distinguishing features include the bland cytologic appearance of the epithelium and the identification of associated endometrial stromal cells, which help confirm the benign nature of the process. This paper is centrally about endometriosis — specifically focusing on the histological presentation and differential diagnosis of superficial cervical involvement.

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Abstract

Twenty cases of superficial endometriosis of the uterine cervix that occurred in patients from 20 to 51 (mean 37.1) years of age are described. The majority of the cases were seen in consultation and were usually referred because of diagnostic problems; endocervical glandular dysplasia, adenocarcinoma in situ, or rarely invasive adenocarcinoma were a frequent consideration of the contributor. The endometriosis was almost always an incidental microscopic finding. The endometriotic foci were usually confined to the superficial third of the cervical wall, but in one case there was also involvement of the middle third of the cervical wall. Deep cervical endometriosis was not present in any case. The endometriotic glands were typically evenly spaced and were surrounded at least focally by endometriotic stroma in all cases. The endometriotic stromal cells, however, were significantly obscured by inflammatory cells (two cases), inflammatory cells and hemorrhage (two cases), hemorrhage (four cases), and in one case by smooth muscle metaplasia causing initial failure to recognize the stromal component of the process. The presence of mitotic figures in the glandular epithelium contributed to an initial diagnosis of a premalignant or malignant glandular lesion being made or seriously entertained in 10 cases. Awareness that mitotic figures may be conspicuous in endometriosis from women of reproductive age, the usually bland cytologic features of the endometriotic epithelium, and the presence of associated endometrial stromal cells all facilitate establishing the correct diagnosis.
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Superficial Endometriosis of the Uterine Cervix A Report of 20 Cases of a Process that May Be Confused with Endocervical Glandular Dysplasia or Adenocarcinoma in Situ - Patricia M. Baker - Philip B. Clement - Debra A. Bell - Robert H. Young Summary: Twenty cases of superficial endometriosis of the uterine cervix that occurred in patients from 20 to SI (mean 37.1) years of age are described. The majority of the cases were seen in consultation and were usually referred because of diagnostic problems; endocervical glandular dysplasia, adenocarcinoma in situ, or rarely invasive adenocarcinoma were a frequent consideration of the contributor. The endometriosis was almost always an incidental microscopic finding. The endometriotic foci were usually confined to the superficial third of the cervical wall, but in one case there was also involvement of the middle third of the cervical wall. Deep cervical endometriosis was not present in any case. The endometriotic glands were typically evenly spaced and were surrounded at least focally by endometriotic stroma in all cases. The endometriotic stromal cells, however, were significantly obscured by inflammatory cells (two cases), inflammatory cells and hemorrhage (two cases), hemorrhage (four cases), and in one case by smooth muscle metaplasia causing initial failure to recognize the stromal component of the process. The presence of mitotic figures in the glandular epithelium contributed to an initial diagnosis of a premalignant or malignant glandular lesion being made or seriously entertained in 10 cases. Awareness that mitotic figures may be conspicuous in endometriosis from women of reproductive age, the usually bland cytologic features of the endometriotic epithelium, and the presence of associated endometrial stromal cells all facilitate establishing the correct diagnosis.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Endometriosis Uterine Cervical Diseases Uterine Cervical Dysplasia Uterine Cervical Neoplasms Adult Biopsy Cell Nucleus Cell Nucleus Cervix Uteri Cervix Uteri Cytoplasm Cytoplasm Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans Middle Aged

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