Glandular lesions of the uterine cervix

During the past 20 years, pathologists have more carefully examined and mor e precisely classified glandular lesions of the endocervix, largely reflect ing increased concerns about the diagnosis and pathogenesis of adenocarcino ma of the cervix This review of glandular lesions of the cervix focuses on the following six issues surrounding the histologic diagnosis of the more c ommon types of adenocarcinoma of the endocervix and their mimics: (1) the c lassification and recognition of preinvasive glandular lesions, (2) the dis tinction of invasive from preinvasive adenocarcinoma, (3) the definition an d significance of microinvasive adenocarcinoma, (4) the epidemiology and pa thogenesis of adenocarcinoma, (5) the identification and behavior of the mo re common subtypes of invasive adenocarcinoma, and (6) the recognition of b enign lesions that mimic adenocarcinoma, It is the author's opinion that most in situ and invasive adenocarcinomas o f the cervix can be recognized and distinguished from benign mimics. In con trast, glandular dysplasia and microinvasive adenocarcinoma of the cervix a re currently ill-defined and irreproducible terms that should not be used f or diagnostic purposes. Although only brief descriptions of the biologic be havior of the various lesions and their therapy are included in this review , certain variants of endocervical adenocarcinoma have distinctive behavior s and should be classified appropriately to provide prognostication and hel p to guide therapy.