Cervix
Benign / nonneoplastic epithelial lesions
Decidual reaction
Authors: Branko Perunovic, D.M., Marilin Rosa, M.D.
Topic Completed: 1 May 2007
Minor changes: 5 March 2020
Copyright: 2007-2021, PathologyOutlines.com, Inc.
PubMed search: Decidual reaction [title]
Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Perunovic B., Rosa M. Decidual reaction. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixdecidual.html. Accessed January 22nd, 2021.
Definition / general
- Also called cervicitis decidualis, deciduous
- Multiple small, yellow / red elevations of cervical mucosa
- Soft, friable, bleed easily; rarely are fungating and resemble carcinoma
- Identified cytologically in 1/3 of patients with histologically confirmed decidual reaction (Acta Cytol 1981;25:616)
- Clinical history of pregnancy is important to avoid misdiagnosis of dysplasia
Case reports
- 28 year old pregnant woman with hemorrhage and abnormal colposcopy resembling invasive cervical carcinoma (J Low Genit Tract Dis 2005;9:52)
- 31 year old woman with decidual change in lymph nodes mimicking metastatic cervical carcinoma (Arch Pathol Lab Med 2005;129:e117)
- 35 year old pregnant woman presented with growing nodule on cervix (Case of the Month #480)
- Patient with radical hysterectomy for cervical carcinoma (Eur J Gynaecol Oncol 2005;26:499)
Microscopic (histologic) description
- Decidual cells with abundant pale granular cytoplasm, bland nuclei
Microscopic (histologic) images
Cytology description
- Cells occur in aggregates or singly, have abundant cytoplasm, marked nuclear enlargement with finely granular chromatin and prominent nucleoli
- Cell size is similar to mature squamous cells
Positive stains
- Vimentin, desmin, alpha-1-antitrypsin
- Variable PLAP, beta hCG
Negative stains
Differential diagnosis
Board review style question #1
Which of the following is true about cervical deciduosis?
A. Cervical deciduosis is a dysplastic change in the cervix.
B. The true incidence of cervical deciduosis is unknown but it is thought to be common during pregnancy.
C. Gross examination allows a straightforward assessment of cervical deciduosis versus other entities in the cervix.
D. Cervical deciduosis, also called ectopic deciduosis, has only been reported in organs of the gynecological tract.
E. Cervical deciduosis is a diagnosis of exclusion.
A. Cervical deciduosis is a dysplastic change in the cervix.
B. The true incidence of cervical deciduosis is unknown but it is thought to be common during pregnancy.
C. Gross examination allows a straightforward assessment of cervical deciduosis versus other entities in the cervix.
D. Cervical deciduosis, also called ectopic deciduosis, has only been reported in organs of the gynecological tract.
E. Cervical deciduosis is a diagnosis of exclusion.
Board review style answer #1
B. Since cervical deciduosis is often detected incidentally and is usually asymptomatic, the true incidence is unknown. However, studies have shown the incidence may be as high as 34% of pregnancies.
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Reference: Cervical deciduosis
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Reference: Cervical deciduosis
