REVIEW

Endocervical glandular lesions: controversial aspects and ancillary techniques

W G McCluggage

Correspondence to:
Correspondence to:
Dr W G McCluggage, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BL, UK;
glenn.mccluggage{at}bll.n-i.nhs.uk

The incidence of malignant and premalignant endocervical glandular lesions is increasing. This review covers controversial and difficult aspects regarding the categorisation and diagnosis of these lesions. The terminology of premalignant endocervical glandular lesions is discussed because of the differences between the UK terminology and the widely used World Health Organisation classification. The morphology and histological subtypes of premalignant endocervical glandular lesions are described. Early invasive adenocarcinoma and difficulties in the diagnosis and recognition of this entity are covered, as is the measurement of early invasion within cervical adenocarcinoma. Several benign endocervical glandular lesions can mimic malignant and premalignant endocervical glandular lesions, and the distinction of these benign mimics from premalignant and malignant lesions using ancillary immunohistochemical studies is also covered. Antibodies used to distinguish between endometrial and endocervical adenocarcinoma, in the diagnosis of cervical minimal deviation adenocarcinoma of mucinous type (adenoma malignum), and in the diagnosis of cervical mesonephric lesions are also reviewed.

Abbreviations: AIS, adenocarcinoma in situ; AISM, atypical immature squamous metaplasia; CEA, carcinoembryonic antigen; CGIN, cervical glandular intraepithelial neoplasia; CIN, cervical intraepithelial neoplasia; EGD, endocervical glandular dysplasia; ER, oestrogen receptor; HCGIN, high grade cervical glandular intraepithelial neoplasia; HPV, human papillomavirus; LCGIN, low grade cervical glandular intraepithelial neoplasia; MDA, minimal deviation adenocarcinoma; MGH, microglandular hyperplasia; PAS, periodic acid Schiff; TEM, tubo-endometrial metaplasia; WHO, World Health Organisation

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