Nucci Marisa R
Division of Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
Int J Gynecol Pathol. 2014 Jul;33(4):330-8. doi: 10.1097/PGP.0000000000000139.
Pseudoneoplastic glandular lesions of the cervix continue to be diagnostically challenging for the surgical pathologist. This review covers a select number of these lesions that may be misinterpreted as premalignant or malignant, with an emphasis on those about which Dr Scully has advanced our knowledge. The topics covered include microglandular hyperplasia, mesonephric hyperplasia, diffuse laminar endocervical glandular hyperplasia, lobular endocervical glandular hyperplasia, and endocervical adenomyoma. The first listed entity has a greater diversity of morphology than the name might imply including, but not limited to solid growth and prominent hyaline stroma. The second entity may be remarkably diffuse within the cervical wall and reasonably result in consideration of diagnoses such as minimal deviation adenocarcinoma (adenoma malignum), but has nonmucinous epithelium and bland cytology. The third entity, one of the least common of those considered, represents a peculiar form of reactive hyperplasia of the endocervical epithelium. The fourth entity is the one about which knowledge is still fast advancing. In pure form with no atypia it is almost certainly a clinically benign process, but a subset of cases show cytologic atypia and an occasional association with adenocarcinoma is seen. Finally, adenomyomas of the uterus in general have received much attention in recent years, mostly in the corpus, but the less common endocervical variant may be particularly problematic because mucinous epithelium in abundant myogenic stroma may be potentially confused with an infiltrating differentiated mucinous adenocarcinoma. Although immunohistochemistry may play a role on occasion in evaluating benign endocervical glandular proliferations the mainstay of their interpretation remains conventional morphologic analysis of routinely stained slides.
子宫颈的假肿瘤性腺性病变对外科病理学家来说在诊断上仍然具有挑战性。本综述涵盖了一些可能被误诊为癌前病变或恶性病变的此类病变，重点关注那些Scully医生使我们对其认识有所进展的病变。涵盖的主题包括微腺型增生、中肾增生、弥漫性层状宫颈内膜腺性增生、小叶性宫颈内膜腺性增生和宫颈内膜腺肌瘤。第一个列出的实体的形态多样性比其名称所暗示的要大，包括但不限于实性生长和显著的透明质间质。第二个实体在宫颈壁内可能非常弥漫，合理地会导致考虑诸如微小偏离腺癌（恶性腺瘤）等诊断，但具有非黏液性上皮和温和的细胞学表现。第三个实体是所考虑的病变中最不常见的之一，代表宫颈内膜上皮一种特殊形式的反应性增生。第四个实体是知识仍在快速发展的一个。在无异型性的纯形式下，它几乎肯定是一个临床良性过程，但一部分病例显示细胞学异型性，偶尔可见与腺癌相关。最后，子宫腺肌瘤近年来总体上受到了很多关注，主要是在子宫体部，但较不常见的宫颈内膜型可能特别成问题，因为丰富的肌源性间质中的黏液性上皮可能会与浸润性分化型黏液腺癌混淆。尽管免疫组织化学偶尔可能在评估良性宫颈内膜腺性增生中发挥作用，但其解读的主要依据仍然是对常规染色切片进行传统形态学分析。
