Inflammatory / infectious

Chronic cervicitis

Editorial Board Member: Carlos Parra-Herran, M.D.
Deputy Editor-in-Chief: Jennifer A. Bennett, M.D.
Ali Ismail, M.B.B.S.
Ziyan T. Salih, M.D.

Last author update: 9 December 2021
Last staff update: 15 December 2022

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PubMed Search: Chronic cervicitis

Ali Ismail, M.B.B.S.
Ziyan T. Salih, M.D.
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Cite this page: Ismail A, Salih ZT. Chronic cervicitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixchroniccervicitis.html. Accessed March 27th, 2023.
Definition / general
  • Dense infiltrate of plasma cells and small lymphocytes with follicle formation in superficial cervical stroma, predominantly due to irritation (chemical or procedural) or infection (HSV, Chlamydia)
  • Papillary endocervicitis is an endocervical inflammatory process with papillary growth pattern
Essential features
  • Predominantly lymphocytic inflammation of the transformation zone of cervix
  • Ulceration and necrosis suggest infective etiology
  • Viral inclusions or lymphoid aggregates may point towards a chlamydia infection
  • Chronic nonspecific cervicitis, follicular cervicitis, plasma cell cervicitis, infective cervicitis
ICD coding
  • ICD-10: N72 - inflammatory disease of cervix uteri
  • Transformation zone of the cervix
  • Infection (chlamydia, herpes simplex virus, syphilis, Candida)
  • Inflamed or traumatized Nabothian cysts
  • Intrauterine device use (Eur J Contracept Reprod Health Care 2014;19:187)
  • Foreign bodies (tampons, diaphragms, pessaries)
  • Idiopathic
Clinical features
  • Redness or induration on physical examination; chronic inflammation of the cervix on pap smear or histologic evaluation
Case reports
  • Infectious cervicitis requires antimicrobial treatment
  • Noninfectious cervicitis generally does not require treatment
Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Ali Ismail, M.B.B.S.

Chronic inflammation

Cytology description
Cytology images

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Lymphofollicular cervicitis in a
53 year old woman

Sample pathology report
  • Cervix, biopsy:
    • Squamous mucosa with nonspecific chronic inflammation
  • Cervix, biopsy:
    • Squamocolumnar junction mucosa with dense inflammation, ulceration and epithelial viral cytopathic changes consistent with herpes simplex infection
Differential diagnosis
  • Lymphoma:
    • Monomorphic lymphoid population, large lymphoid cells seen in cases with diffuse large B cell lymphoma
    • Negative for viral immunohistochemical stains
    • Most are B cell lymphomas and express pan-B cell markers
    • Clonal IGH rearrangements
  • Florid reactive lymphoid hyperplasia:
    • Superficial aggregates of large lymphoid cells with admixed small lymphocytes, macrophages and germinal center formation
    • Negative for viral immunohistochemical stains
    • Mixture of B cells, T cells and polytypic plasma cells
    • May show clonal IGH rearrangements (Am J Surg Pathol 2010;34:161)
Board review style question #1
Which of the following causes of chronic cervicitis is associated with multinucleated cells with ground glass chromatin with eosinophilic nuclear inclusions?

  1. Adenocarcinoma in situ
  2. Arias-Stella reaction
  3. Atrophy
  4. High grade squamous intraepithelial lesion
  5. Herpes simplex virus (HSV) cervicitis
Board review style answer #1
E. Herpes simplex virus (HSV) cervicitis

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Reference: Chronic cervicitis
Board review style question #2

A 33 year old woman presented with pain and erythema of the cervix. A biopsy was performed and the histologic features are shown above. Which of the following is a possible diagnosis?

  1. Adenocarcinoma in situ
  2. Arias-Stella reaction
  3. Atrophy
  4. Chronic cervicitis
  5. High grade squamous intraepithelial lesion
Board review style answer #2
D. Chronic cervicitis

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Reference: Chronic cervicitis
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