Tubal Metaplasia of the Uterine Cervix

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Abstract
Tubal metaplasia (TM) of endocervical epithelium may be confused with endocervical dysplasia or adenocarcinoma in histologic or cytologic specimens. However, the potential magnitude of this problem is unknown, because the prevalence of endocervical TM in routine surgical pathology material is undefined. To determine the prevalence, distribution, and associated features of endocervical TM, we retrospectively reviewed a consecutive series of cone biopsy specimens (n = 82) and hysterectomy specimens in which the entire cervix had been sectioned (n = 26), obtained over 28-months. Tubal metaplasia was defined as epithelium containing all three cell types (ciliated, secretory, and intercalary) found in the normal fallopian tube. The mean patient age was 41 years (range, 21-79). Endocervical TM was present in 33 of 108 patients (31%) and was evenly distributed among all age groups. Its prevalence was related to the number of sections examined (23% of cases with less than or equal to 12 blocks of the cervix; 52% of cases with greater than 12 blocks; p less than 0.01) and was greater in hysterectomy than in cone specimens (62 vs. 21%, p less than 0.001). Although most frequent in the upper endocervix and in deep portions of glands, TM involved the surface in 36%, the superficial parts of glands in 64%, and the lower endocervix in 30% of positive cases. There was no association with phase of the menstrual cycle, inflammatory changes, or low-grade cervical intraepithelial neoplasia (CIN), but TM was inversely related to high-grade CIN in glands, presumably due to replacement of metaplastic cells by neoplastic cells.(ABSTRACT TRUNCATED AT 250 WORDS)

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