These glandular groups show some features worrisome for endocervical neoplasia, including hyperchromasia, nuclear pleomorphism, crowding and overlapping. At high magnification some nuclei display grooves and focal contour irregularities.
They also exhibit terminal bars.
Cilia can be clearly seen in numerous groups having similar nuclear features.
Diagnosis: Tubal metaplasia.
Tubal metaplasia enters into the differential diagnosis of endocervical neoplasia (in particular adenocarcinoma in situ (AIS)) because of the nuclear and architectural abnormalities previously discussed. Nuclear pleomorphism may also be prominent. Recognition of terminal bars and cilia permits identification of tubal metaplasia; however depending on the orientation of the glandular groups and degree of preservation these features may be difficult to see. Rosettes, feathered edges and mitotic figures (other features noted in AIS) are uncommon in tubal metaplasia.
Other benign mimics of endocervical neoplasia include marked reactive changes/repair, brush artifact, endometrial cells (including inadvertent endometrial sampling following cone biopsy) and Arias-Stella reaction.
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