Cervix
Benign / nonneoplastic lesions
Lobular endocervical glandular hyperplasia (LEGH)

Author: Carlos Parra-Herran, M.D. (see Authors page)

Revised: 16 May 2017, last major update May 2017

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Lobular endocervical glandular hyperplasia cervix

Cite this page: Lobular endocervical glandular hyperplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixlobularendocerv.html. Accessed July 27th, 2017.
Definition / general
  • Rare; first described in 1999 (Am J Surg Pathol 1999;23:886)
  • LEGH is part of the spectrum of pyloric gland metaplasia in the uterine cervix (Am J Surg Pathol 2000;24:325)
  • Mean age 45 years, range 37 to 71 years
  • Usually an incidental finding but 37% have a visible gross abnormality or clinical symptoms
  • Benign, does not recur
  • Considered a non obligatory precursor lesion of gastric type endocervical adenocarcinoma (Adv Anat Pathol 2013;20:227, Mod Pathol 2005;18:1199)
  • Atypical LEGH has been recently proposed as a lesion distinct from conventional LEGH
  • It is also strongly associated with minimal deviation adenocarcinoma / adenoma malignum (MDA), seen in 30% of cases
Microscopic (histologic) description
  • Micro description
  • Usually confined to inner half of cervical wall
  • Well demarcated lesion with lobular / acinar architecture composed of a central gland(s), sometimes with cystic dilation, surrounded by smaller glands and cysts arranged in a floret-like pattern
  • Central and peripheral glands are lined by columnar cells with pale eosinophilic cytoplasm
  • May have mild reactive nuclear atypia
  • Non invasive, no desmoplasia, no mitotic figures, no squamous differentiation
  • Atypical LEGH is defined as architecturally consistent with LEGH but with 4 or more of the following features:
    • Nuclear enlargement
    • Irregular nuclear contours
    • Distinct nucleoli and coarse chromatin
    • Loss of polarity
    • Mitotic figures (occasional)
    • Apoptotic bodies or luminal nuclear debris
    • Intraluminal papillary projections
Microscopic (histologic) images

Images hosted on Pathout server:
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Contributed by Carlos Parra-Herran, M.D.


Images hosted on other servers:
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Endocervical adenocarcinomas
associated with lobular endocervical
glandular hyperplasia
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Benign glandular cells
with golden yellow mucin
(figures c and d)
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Atypical LEGH

Cytology description
  • High columnar mucinous cells with no atypia and no / rare mitotic figures
  • Benign looking glandular cells with intracytoplasmic golden yellow mucin (Diagn Cytopathol 2002;27:80)
  • Intranuclear cytoplasmic inclusions usually are present
Positive stains
Negative stains
Molecular / cytogenetics description
Differential diagnosis