Ectopic prostatic tissue in the uterine cervix. Report of a case and brief overview of basaloid cervical glandular lesions

Abstract

Figure 3 Ectopic prostatic tissue, medium power. Insert high-molecular weight keratin (34bE12).

Uncommon Cervical Lesions: A Review and Discussion of the Differential Diagnosis

“…Prostatic-type tissue in the female genital tract is a phenomenon first described in the uterine cervix in 1997, 90 with subsequent literature expanding the clinicopathologic picture of the lesions. [91][92][93][94][95][96][97][98][99][100] The prostatic-type tissue is composed of glands identical in morphology and immunohistochemical staining to male prostatic glands, and frequently lined by basal cells (Figure 7, A). Early studies reported the presence of prostatic glands within the lamina propria of the uterine cervix, sparing the squamous epithelium, but with frequent and often extensive squamous metaplasia in the prostatic-type glands, with the potential for misdiagnosis as squamous cell carcinoma when identified deep within the stroma (Figure 7, B through D).…”

“…Early studies reported the presence of prostatic glands within the lamina propria of the uterine cervix, sparing the squamous epithelium, but with frequent and often extensive squamous metaplasia in the prostatic-type glands, with the potential for misdiagnosis as squamous cell carcinoma when identified deep within the stroma (Figure 7, B through D). [90][91][92][93][94]100 In some cases, the squamous component almost entirely obscures the glandular component. Most cases in these early studies were identified incidentally during evaluation of squamous intraepithelial lesions, with rare presentation as a clinically identified mass.…”

“…Most cases in these early studies were identified incidentally during evaluation of squamous intraepithelial lesions, with rare presentation as a clinically identified mass. 91 Immunohistochemically, the lesions have been reported to be reactive with prostate- specific antigen, [90][91][92][93][94][95]97,99,100 prostate-specific acid phosphatase, [90][91][92][93][94][95]97,100 androgen receptor, 99,100 NKX3.1, 98,99 and CK7. 99 High-molecular-weight CK shows positivity in the basal cell layer if present.…”

“…99 High-molecular-weight CK shows positivity in the basal cell layer if present. 91,92,94,95,100 In one study, ER and progesterone receptor (PR) staining were performed and were negative in the glands, with the exception of ER positivity in areas of squamous metaplasia. 100 The origin of the prostatic-type glands in the cervix is not completely understood, but they have been theorized to arise from teratomatous tissue, developmental abnormalities (such as misplacement of paraurethral Skene glands during embryonic development), mesonephric remnants, or metaplasia of endocervical glands.…”

“…100 The origin of the prostatic-type glands in the cervix is not completely understood, but they have been theorized to arise from teratomatous tissue, developmental abnormalities (such as misplacement of paraurethral Skene glands during embryonic development), mesonephric remnants, or metaplasia of endocervical glands. [90][91][92]94 Recognition of prostatic metaplasia in patients with congenital or exogenous androgen excess led to the postulation that androgens may play a role in the development. 92,99 Similar lesions have been described in the vagina (tubulosquamous polyps) and vulva.…”