Cervix
Benign / nonneoplastic epithelial lesions
Microglandular hyperplasia

Editorial Board Member: Ricardo R. Lastra, M.D.
Deputy Editor-in-Chief: Jennifer A. Bennett, M.D.
Gulisa Turashvili, M.D., Ph.D.

Topic Completed: 15 February 2021

Minor changes: 15 February 2021

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PubMed Search: Microglandular hyperplasia cervix

Gulisa Turashvili, M.D., Ph.D.
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Cite this page: Turashvili G. Microglandular hyperplasia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixMGH.html. Accessed March 3rd, 2021.
Definition / general
  • Benign, nonneoplastic endocervical glandular proliferation
Essential features
  • Benign lesion not requiring treatment
  • Usually incidental microscopic finding in reproductive women
  • Associated with hormonal exposure (pregnancy, postpartum, oral contraceptive pills, hormone replacement therapy)
  • May mimic cervical and endometrial adenocarcinomas
Terminology
  • Microglandular adenosis
  • Microglandular change
Epidemiology
  • Common in reproductive age women, rarely postmenopausal
  • Typically incidental
Sites
  • Cervix
Etiology
Clinical features
  • Usually asymptomatic
  • May present with contact bleeding
  • May form solitary or multiple polypoid masses (Arch Pathol Lab Med 2010;134:393)
  • May involve an endocervical polyp
Diagnosis
  • Microscopic examination
Prognostic factors
  • Excellent prognosis
Case reports
Treatment
  • Not required
Gross description
Microscopic (histologic) description
  • Solitary or multiple polypoid lesions
  • Often superficial location
  • Complex proliferation of back to back tubular or cystically dilated glands with scant intervening stroma
  • Intraluminal mucin with acute inflammation
  • Mixed stromal inflammatory infiltrate
  • May be associated with immature or mature squamous metaplasia
  • Glands are lined by bland cuboidal, columnar or flattened cells with subnuclear and supranuclear vacuoles (may not be well developed in some cases), indistinct nucleoli, absent or rare (≤ 3 per 10 high power fields) mitoses (Int J Gynecol Pathol 2003;22:261)
  • Variable reserve cells or immature squamous cells beneath endocervical cells
  • Rare unusual features (atypical microglandular hyperplasia):
Microscopic (histologic) images

Contributed by Gulisa Turashvili, M.D., Ph.D.
Benign glandular proliferation

Benign glandular proliferation

Back to back glands lacking atypia

Back to back glands lacking atypia

Bland epithelial lining

Bland epithelial lining

Rare mitosis

Rare mitosis

Virtual slides

Images hosted on other servers:

Classic microglandular hyperplasia

Solid form of microglandular hyperplasia

Microglandular hyperplasia and nabothian cysts

Microglandular hyperplasia in endocervical polyp


p16 stain in microglandular hyperplasia

Ki67 stain in microglandular hyperplasia

Endometrial carcinoma
mimicking microglandular
hyperplasia

Cytology description
  • Nonspecific changes
  • Spectrum of benign appearing to bi or tridimensional clusters of cuboidal or columnar glandular cells with vacuolated cytoplasm, microlumina or fenestration (Acta Cytol 1999;43:110)
  • Admixture of cells with immature squamous metaplasia and reserve cells with scant cytoplasm and small, round nuclei (Diagn Cytopathol 2004;30:57, Acta Cytol 1999;43:110)
  • Inflammatory cells
  • Glandular cells may show cytologic atypia with enlarged, hyperchromatic, crowded nuclei, smooth nuclear contours, fine chromatin, sometimes multiple nucleoli, mitoses, apoptotic bodies and watery diathesis, mimicking high grade squamous intraepithelial lesion (Diagn Cytopathol 1994;10:326, Acta Cytol 2000;44:661)
Cytology images

Images hosted on other servers:

Isolated rounded endocervical cells

Negative stains
Sample pathology report
  • Endocervix, curettings:
    • Fragments of benign endocervical tissue
    • (Microglandular hyperplasia need not be reported; may be included in microscopic description)
Differential diagnosis
Board review style question #1

Which of the following entities is the closest mimic of microglandular hyperplasia?

  1. Endometrial serous carcinoma
  2. Nabothian cysts
  3. Clear cell carcinoma
  4. Minimal deviation adenocarcinoma
  5. Endometrial endometrioid carcinoma, microglandular pattern (microglandular hyperplasia-like endometrioid adenocarcinoma)
Board review style answer #1
E. Endometrial endometrioid carcinoma, microglandular pattern (microglandular hyperplasia-like endometrioid adenocarcinoma)

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Reference: Microglandular hyperplasia
Board review style question #2
Which of the following statements is true for microglandular hyperplasia?

  1. Microglandular hyperplasia is a nonobligate precursor of usual type endocervical adenocarcinoma
  2. Microglandular hyperplasia is often seen in patients with Cowden syndrome
  3. Microglandular hyperplasia is associated with increased risk of clear cell carcinoma
  4. Microglandular hyperplasia is often associated with endometrial endometrioid adenocarcinoma, microglandular pattern
  5. Microglandular hyperplasia is usually an incidental finding in women of reproductive age
Board review style answer #2
E. Microglandular hyperplasia is usually an incidental finding in women of reproductive age

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Reference: Microglandular hyperplasia
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