Recent advances in the diagnosis and classification of endocervical glandular lesions

Ancillary testing in liquid based cytology to distinguish cervical glandular neoplasia from tuboendometrial metaplasia in a young woman

A 33-year old woman had a cervical sample taken at colposcopy clinic. Seven years prior to this, at the age of 26, she had had a cytological diagnosis of cervical glandular neoplasia (cytology descriptor indicated cells suspicious of endocervical neoplasia) and severe dyskaryosis. Confirmation and treatment were by LLETZ and knife cone, and, in keeping with England and Wales National Health Service guidelines, this woman was under follow-up by the colposcopy clinic. Intervening cytological follow-up included a number of negative cytological samples interspaced with one equivocal report. A recent repeat cytology which was rather cellular contained several hyperchromatic crowded cell groups (HCCG's). Careful examination revealed benign endometrial clusters, LUS, TEM and endocervical cells in strips showing pseudostratification and loss of polarity. Following an agar block, there was positive staining for p16 and Ki-67 in the abnormal groups whilst the benign TEM cells stained positive for bcl-2.

[Endometrial and endocervical lesions associated with pseudomyxoma peritonei: a case report]

The association of a pseudomyxoma peritonei with a mucinous tumor of the appendix and/or the ovary is regularly reported in the literature. However, in this context, endometrial or endocervical lesions remain exceptional. We report the case of a 57-year-old patient, with pseudomyxoma peritonei associated with a low-grade mucinous neoplasia of appendix and both ovaries. The systematic sampling of endometrium and endocervix showed small segments of intestinal epithelium admixed with native epithelium. Histological and immunohistochemical characteristics of this epithelium were quite comparable to those observed in the appendix and ovaries. The endocervical and endometrial lesions might represent an implantation of mucinous epithelium from appendix, emphasizing the capacity of this epithelium to implant at a distance from the original lesion.