Intestinal-type metaplasia in the original squamous epithelium of the cervix

Department of Pathology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
European journal of gynaecological oncology (Impact Factor: 0.61). 01/2010; 31(3):319-22.
Source: PubMed


There have been a number of reports on cervical carcinomas, both invasive and intraepithelial (CIN III), indicating the presence of intracellular mucins in the absence of glandular differentiation. Yet, the expression of such cells in the normal/original squamous epithelium of the cervix remains unexplored. We investigated the presence of mucin-distended goblet cells at this site, after examining retrospectively normal cervices from 250 hysterectomy specimens. Goblet cells were detected in 3.2% (8/250) of the cervices examined using haematoxylin and eosin stained sections and confirmed by mucin histochemistry: alcian blue (AB) pH 2.5, periodic acid-Schiff reaction with and without diastase digestion (PAS-d, PAS) and the combined AB/PAS. Additional sections were stained with Diazo and Masson-Fontana for argentaffin granules and Grimelius for argyrophil cells, but were all negative and no other cell types were identified. It is believed that this incomplete type of intestinal metaplasia is an acquired change in the cervix, derived from multi-potential stem cells of Müllerian duct origin.

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    ABSTRACT: AIM:: To evaluate the immunohistochemical expression of several benign or malignant mucinous lesions that can be encountered in endometrial curettage material. MATERIALS AND METHODS:: Nineteen well-differentiated mucinous endometrial carcinomas, 12 papillary mucinous metaplasias, 11 cervical microglandular hyperplasias, 11 endocervical adenocarcinomas, 2 goblet cell metaplasias, 1 minimal-deviation adenocarcinoma, and 1 lobular endocervical glandular hyperplasia entered the study. Immunohistochemistry was performed with the following antibodies against: estrogen receptors, progesterone receptors, vimentin, p16, p63, carcinoembryonic antigen, and Ki-67. RESULTS:: Immunohistochemistry could easily distinguish endocervical adenocarcinoma of usual type from all other lesions under study. A Vim/p16/p63 signature was found to favor a cervical microglandular hyperplasia, whereas both mucinous endometrial carcinoma and mucinous papillary metaplasia would be preferentially characterized by a Vim/p16/p63 immunophenotype. A high Ki-67 expression would be of help in differentiating the latter 2 conditions. Statistically, the expression of estrogen receptors, progesterone receptors, and carcinoembryonic antigen did not aid in the differential diagnosis of these 3 conditions. For the 4 cases representing goblet cell metaplasia, minimal-deviation adenocarcinoma and lobular endocervical glandular hyperplasia, no results could be drawn. CONCLUSIONS:: In endometrial curettage material, the differential diagnosis of lesions comprising mucinous epithelium might be rendered by combining the immunohistochemical expression of vimentin, p16, p63, and Ki-67. Of all lesions, endocervical adenocarcinoma of usual type is the most easily identified.
    Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry 04/2012; 20(6). DOI:10.1097/PAI.0b013e31825251a4 · 2.01 Impact Factor

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