Papillary Immature Metaplasia of the Uterine Cervix: a Report of 5 Cases with an Emphasis on the Differential Diagnosis from Reactive Squamous Metaplasia, High-Grade Squamous Intraepithelial Lesion and Papillary Squamous Cell Carcinoma.
10.3346/jkms.2001.16.6.762
- Author:
Gil Hyun KANG
1
;
Kwangseon MIN
;
Yong Hee SHIM
;
Kyu Rae KIM
Author Information
1. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. krkim@www.amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Metaplasia;
Cervix Neoplasms;
Carcinoma, Papillary;
Papillomavirus;
Ki-67 Antigen;
Protein p53
- MeSH:
Adult;
Carcinoma in Situ/*pathology;
Carcinoma, Papillary/*pathology;
Carcinoma, Squamous Cell/*pathology;
Cervix Neoplasms/*pathology;
DNA, Viral/analysis;
Diagnosis, Differential;
Epithelial Cells/chemistry/pathology;
Female;
Follow-Up Studies;
Human;
Ki-67 Antigen/analysis;
Papillomavirus/genetics;
Papillomavirus Infections/pathology;
Protein p53/analysis;
Tumor Virus Infections/pathology;
Vaginal Smears
- From:Journal of Korean Medical Science
2001;16(6):762-768
- CountryRepublic of Korea
- Language:English
-
Abstract:
Papillary immature metaplasia (PIM) is a distinctive exophytic lesion of the uterine cervix and shares some histologic and cytologic features with ordinary squamous metaplasia (SM), atypical immature squamous metaplasia (AIM), high-grade squamous intraepithelial neoplasia (HSIL) and papillary squamous cell carcinoma (PSC). PIM has been suggested to be a subset of condyloma associated with low-risk type human papilloma virus (HPV), however, the etiologic role of HPV and biologic behavior of the disease are still elusive. We compared the clinical and histopathological findings, immunohistochemical expression of Ki-67 and p53 protein, and HPV typing of 5 cases of PIM with SM (n=9), HSIL (n=6), and PSC (n=4) to know the helpful features for the differential diagnosis. Histologically, all 5 cases showed a papillary proliferation of immature metaplastic cells involving the proximal transformation zone and endocervix. On HPV typing by polymerase chain reaction-restriction fragment length polymorphism, 2 out of 5 PIM were confirmed to have HPV 6 or HPV 11, while 2 out of 4 PSC were proved having HPV 31 and HPV 16 each. Ki-67 labeling index and mitotic index of PIM were significantly lower than those of HSIL or PSC. There were no significant differences of Ki-67 labeling index and mitotic index between PIM and SM. The expression of p53 varied among the groups and thus it was not helpful for the differential diagnosis.
