Molero Aida, Parra Alejandro, Blanco Isabel, Ascensión Alfonso, Ortega Pilar
Pathology Department, Complejo Asistencial de Segovia, Segovia, Spain.
SAGE Open Med Case Rep. 2023 Jul 8;11:2050313X231186210. doi: 10.1177/2050313X231186210. eCollection 2023.
Lobular glandular endocervical hyperplasia is an uncommon benign entity within the spectrum of gastric-type endocervical lesions. We report a case of a 48-year-old woman who presented with a palpable mass and watery vaginal discharge. Ultrasound revealed an 8 cm × 4 cm × 3 cm multicystic mass affecting the cervix, and hysterectomy was performed. The well-delimited multicystic, mucinous mass distorted the entire cervix. Microscopically, endocervical glandular proliferation with a lobular architecture was observed. The glands were lined with a single layer of tall, mucin-rich, columnar cells with basal and bland nuclei. The lesion was positive for MUC6 marker and hormonal receptors were negative, while P53 expression was normal. Three years later, the patient remained disease free. Here, we discuss the differential diagnosis between lobular glandular endocervical hyperplasia and similar conditions, particularly gastric-type endocervical adenocarcinoma, and review the literature focusing on the molecular pathways underlying gastric-type endocervical lesions. This case highlights the importance of accurate diagnosis to ensure favorable outcomes.
小叶状宫颈腺性增生是胃型宫颈病变范围内一种罕见的良性病变。我们报告一例48岁女性病例，该患者出现可触及的肿块及水样阴道分泌物。超声检查发现一个8 cm×4 cm×3 cm的多囊性肿块累及宫颈，遂行子宫切除术。界限清楚的多囊性黏液性肿块使整个宫颈变形。显微镜下，可见具有小叶结构的宫颈腺性增生。腺体内衬单层高柱状、富含黏液的细胞，细胞核位于基底且形态温和。该病变MUC6标记物呈阳性，激素受体为阴性，而P53表达正常。三年后，患者无疾病复发。在此，我们讨论小叶状宫颈腺性增生与类似疾病，尤其是胃型宫颈腺癌之间的鉴别诊断，并回顾聚焦于胃型宫颈病变潜在分子途径的文献。该病例突出了准确诊断以确保良好预后的重要性。
