Benign / nonneoplastic epithelial lesions

Decidual reaction

Last author update: 1 May 2007
Last staff update: 25 July 2022

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PubMed search: Decidual reaction [title]

Branko Perunovic, D.M.
Marilin Rosa, M.D.
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Cite this page: Perunovic B., Rosa M. Decidual reaction. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixdecidual.html. Accessed August 17th, 2022.
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
Microscopic (histologic) description
  • Decidual cells with abundant pale granular cytoplasm, bland nuclei
Microscopic (histologic) images

Contributed by Aung Phyo, M.D.
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
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.
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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