Editorial Introduction
Thomas F. Purdon, MD, FACOG

Happy New Year to all! After a brief hiatus, we are now back online again with some of the most up to date and interesting information about “trends” in cervical health and disease that you will find in one easy-to-access location. I am pleased to be able to report that Hologic, our educational sponsor, is committed to helping us with resources to once again put this e-newsletter online.

Please read along for an overview of this issue and what future issues will bring.

 

Case Study

Paul M. Norris, MD
Leo B. Twiggs, MD

This interesting case study, complete with photos, reviews a 22 year old G0 patient was referred for a colposcopy secondary to a pap-smear remarkable for low grade squamous intra-epithelial neoplasia (LGSIL).

Considerations for Adding Molecular Testing to Your Lab
Tim Feit, CT (ASCP)
Michele Smith, SCT(ASCP)

The Papanicolaou (Pap) screening test has long been proven effective in early detection and diagnosis of cervical cancer and precancerous lesions. In the 1990s, liquid-based cytology changed the Pap test in terms of collection and evaluation. The past decade has seen molecular testing move from a reference test to an in-house test in many laboratories. Many laboratories are now wondering whether they can effectively and efficiently bring in molecular testing. Depending on state regulations, the types of molecular tests, staff abilities, and administration support, the answer is a definitive YES.

Colposcopic Features of Microglandular Hyperplasia of the Uterine Cervix
V. Cecil Wright, MD, FRCS(C), FACOG

Microglandular hyperplasia (MGH, also termed microglandular endocervical hyperplasia) was first described in 1967 by Taylor et al. These authors noted atypical endocervical hyperplasia in women taking oral contraceptives. The condition was later described as a florid example of reserve cell hyperplasia with glandular differentiation in response to hormone (predominantly progesterone) stimulation. It was reported in premenopausal women using oral contraceptives and during pregnancy but was unusually observed in postmenopausal women. However, later studies indicated that progesterone, estrogen or their combination was not always implicated. The diagnosis is most frequently made as an incidental microscopic finding on endocervical tissue from sampling (biopsy, excision, hysterectomy).

This article utilizes images to highlight the colposcopic features of this diagnosis.



What is Your Colposcopic Impression?
V. Cecil Wright, MD, FRCS(C), FACOG

The colposcopic prediction of histology is based upon visual inspection of blood vessel configurations, surface contour, color tone and lesion demarcation before and after the application of acetic acid and/or iodine. Various magnifications are used. Many benign, premalignant and malignant squamous conditions have identifiable characteristics. Glandular lesions have less widely appreciated but clearly recognizable features. Colposcopy cannot differentiate between adenocarcinoma in situ and adenocarcinoma. The existence of colposcopic mimics, in which completely different histology produces similar or virtually identical colposcopic appearances, complicates the situation.

In this feature, you will find three case studies demonstrating some of these principles.