Cervical Microglandular Hyperplasia in a Case with High-risk HPV: A Case Study

Background: Cervical microglandular hyperplasia (MGH) is a benign lesion of the cervix that can be misdiagnosed as cervical adenocarcinoma. Its diagnosis has been challenging to both gynecologists and histopathologists and was previously linked to hormonal exposure. Its relationship with the human papilloma virus (HPV) has not been well investigated. 

Case: A young primiparous woman presented with vaginal discharge.On examination, a cervical lesion highly suspicious of malignancywas identified. An HPV PCR test was positive for two high-riskHPV genotypes with negative cytology. The colposcopy showed an irregular papillary cervical massextending into the endocervix that bled on touch. Multiplebiopsies were obtained, and the histopathology examinationconfirmed MGH diagnosis. The patient was followed up with regular HPV testing andcolposcopic procedures. In six months, the cervical lesion hasregressed, and the HPV and cytology were negative.

Conclusion: MGH can be easily confused with cervical cancerdue to their resemblance in presentation,macroscopic and microscopic appearance, whichleads to the misdiagnosis of MGH as cervical cancer. There are still some minor differences between thetwo of them manifested in their glandular structure,cellularity, chromatin content, mitotic activity,nuclear atypia, biological markers, and otherfactors. Knowing these differences will help reduce theincidence of misdiagnosing MGH.