Endocervical reactive atypia: A histologic-cytologic study

Of 1,500 cervical tissue specimens, 27 cases showed histologic changes of r eactive glandular atypia which we defined as endocervical cells with large hyperchromatic, often irregular nuclei, which did not fulfill the criteria for endocervical adenocarcinoma. Eighteen of these 27 cases had preceding o r concurrent cervico-vaginal smears. Six of these showed cells which were s imilar to those seen in histologic sections. The cytologic characteristics of these cells are defined. To determine if atypia is related to inflammato ry-regenerative changes, 29 cases of endocervical polyps were examined, of which 11 showed histologic changes of endocervical reactive atypia; 4 showe d these changes cytologically as well. Twenty-eight cases of routine hyster ectomy specimens were examined, of which 2 cases showed endocervical reacti ve atypia, which indicated that the atypical changes were indeed reactive. Nine out of 27 cases were associated with hormonal usage. Fourteen cases we re associated with squamous intraepithelial lesions or evidence of human pa pilloma virus. Follow-up of our 27 index cases revealed no progression to a denocarcinoma. These findings indicate that atypia, as we define it, of the endocervix can be due to inflammatory-reparative changes or possibly relat ed to hormonal usage, and permit its separation from precursor lesions of e ndocervical adenocarcinoma. Diagn. Cytopathol. 2000;22:342-346. (C) 2000 Wi ley-Liss, Inc.