Uterine prolapse

Uterine prolapse is a frequent benign pathology of the uterus and a common reason for hysterectomy.

General

• Clinical diagnosis.
• A common indication for a total hysterectomy.
• Hysterectomy specimen usually comes with some vaginal mucosa.
• Parous women, usually menopausal.
• Possibly obesity - studies vary.

Gross

• Long cervix.

Microscopic

Features:

• Uterus: non-specific.
• Vaginal mucosa: (focal) keratinization due to rubbing - common finding.

Note:

• Benign stromal atypia may be seen.

Images

• 

  Keratinized cervix - intermed. mag. (WC)

• 

  Keratinized cervix - high mag. (WC)

• 

  Keratinized cervix - very high mag. (WC)

Sign out

Uterus, Cervix and Vagina Mucosa, Total Hysterectomy:
	- Uterine cervix with focal keratinization, otherwise within normal limits.
	- Inactive endometrium.
	- Squamous mucosa with keratinization, consistent with prolapse-associated 
	  changes in the vagina.
	- Medial calcific sclerosis.
	- Atherosclerosis, moderate-to-severe.
	- NEGATIVE for malignancy.

Submitted as "Uterine Cervix", Excision:
- Squamous mucosa with hyperplasia, parakeratosis, and stromal atypia, see comment.
- NEGATIVE for dysplasia and NEGATIVE for evidence of malignancy. 

Comment:
The stromal atypia is favoured to be benign change, as it is without significant proliferation, 
not mass forming and near the stromal-epithelial interface. 

The stromal cells stain as follows:
POSITIVE: vimentin, ER.
NEGATIVE: AE1/AE3, CD10.
PROLIFERATION (Ki-67): <1%.

Block letters

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH FOCAL KERATINIZATION OTHERWISE WITHIN NORMAL LIMITS.
- NONPROLIFERATIVE ENDOMETRIUM.

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH KERATINIZATION, OTHERWISE WITHIN NORMAL LIMITS.
- CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE SMOOTH MUSCLE AND SEROSA WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

Denudated exocervix

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND EXOCERVICAL DENUDATION,
  NO EVIDENCE OF DYSPLASIA.
- CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE CORPUS WITH BENIGN HYALINIZED NODULE.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
Levels were cut on the uterine cervix sections (A1 and A2).

Focal ulceration

- UTERINE CERVIX WITH PARAKERATOSIS, ACANTHOSIS, CHRONIC INFLAMMATION, AND FOCAL
  ULCERATION ASSOCIATED WITH GRANULATION TISSUE FORMATION.
- PARTIALLY CYSTIC NONPROLIFERATIVE ENDOMETRIUM.
- UTERINE CORPUS WITH LEIOMYOMA.
- NO EVIDENCE OF DYSPLASIA.
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

With endometrial polyp

UTERUS AND CERVIX, TOTAL HYSTERECTOMY:
- BENIGN ENDOMETRIAL POLYP WITH NONPROLIFERATIVE ENDOMETRIAL GLANDS.
- UTERINE CERVIX WITH MILD CHRONIC INFLAMMATION AND FOCAL EXOCERVICAL DENUDATION,
  NO EVIDENCE OF DYSPLASIA.
- VERY WEAKLY PROLIFERATIVE ENDOMETRIUM, MOSTLY ATROPHIC APPEARING, NEGATIVE FOR
  ENDOMETRIAL HYPERPLASIA.
- UTERINE CORPUS WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

See also

• Uterus.
• Prolapse.