Atypical polypoid adenomyoma of the uterine cervix: a diagnostic problem

Abstract

IntroductionAtypical polypoid adenomyoma (APA) is an uncommon polypoid lesion of the uterus described first by Mazur in 1981, featuring a proliferation of irregular endometrial glands with squamous metaplasia, embedded within a prominent cellular smooth-muscle stroma. In contrast to adenomyoma, APA contains architecturally complex and cytologically atypical glands that can be confused with well-differentiated adenocarcinoma, but it is distinguished from invasive endometrial carcinoma by its prevalence in younger patients, usually premenopausal women, and by the presence of a cellular, sometimes mitotically active smooth muscle stroma (Longacre et al., 1996). Early clinicopathological series of APAs emphasised the benign clinical character of these proliferations, but the overall prognosis, risk of recurrence and the malignant nature of these problematic lesions are not fully known (Clement and Young, 1987). We report another case of APA of the cervix followed by a discussion on the most appropriate therapeutic measures. To our knowledge, hardly more than 100 cases of this lesion have been reported so far in the English literature (Fukunaga, 1995).

Lesion‐targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

“…We reviewed 27 cases of APAs with cytological findings reported in the English literature (Table 2). 8‐11,13‐26 Seven of those cases involved neither atypical glandular cells nor spindle cells of APAs, similar to Cases 1 and 2. This suggests that cytological sampling of APAs is more difficult than expected.…”

“…In contrast, routine cytology of specimens in Cases 1-5 did not reveal spindle cells (Table 1) We reviewed 27 cases of APAs with cytological findings reported in the English literature (Table 2). [8][9][10][11][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Our data suggest that the LTC method is an appropriate approach to increase the diagnostic accuracy of APAs.…”