Obstetrics and Gynecology - A. M. Gromova 2000

Background and precancerous conditions of the female reproductive organs
Background processes of the female reproductive organs
Cervical polyps

Cervical polyps are pedunculated growths of the mucous membrane lining the endocervical canal. Their development is associated with both hormonal imbalances and inflammatory processes, most commonly occurring in women aged 40–50. Cervical polyps frequently coexist with cervical polyposis, uterine fibroids (leiomyomas), and endometrial glandular hyperplasia.

Polyps can be single or multiple. They are typically rounded in shape with a lobular Structure and a smooth surface. The color of a polyp depends on The Nature of the epithelium covering it. When covered by simple columnar epithelium, the polyp appears pink due to the underlying Blood Vessels showing through. If covered by stratified squamous epithelium, it takes on a whitish hue.

Patients may complain of mucous leukorrhea, and occasionally experience contact bleeding.

Depending on their histological structure, cervical polyps are classified as glandular (adenomatous) or glandular-fibrous. The formation of adenomatous polyps typically originates from localized hyperplasia of endocervical glands. Reserve Cells participate in the formation of these new growths; their hyperplasia first gives rise to epithelial layers, which then develop into intraepithelial glandular structures.

The surface epithelium of the polyps and the Glandular Epithelium consist of tall columnar cells with basally located nuclei. The Cell borders of these columnar cells are well-defined, and the free surface margin is smooth. The Cytoplasm contains mucus droplets, which in some cells concentrate above the nuclei. The cytoplasm of the columnar cells stains metachromatically pink or reddish-purple with toluidine blue. The Glands of the polyps resemble normal cervical-type glands, differing only in their haphazard arrangement. Fully formed polyps of this type, showing no signs of proliferation, are classified as simple (stationary).

Adenomatous polyps may either exhibit signs of growth and progression, or undergo epidermization (squamous metaplasia). In the first scenario—a proliferating adenomatous polyp—reserve cells proliferate in one or more areas beneath the surface columnar epithelium or glandular epithelium, subsequently transforming into new glandular structures (proliferating polyps).

When polyps undergo epithelialization, the stratified squamous epithelium may originate from two different sources. In some cases, it is the stratified squamous epithelium of the exocervix that shifts into the cervical canal and grows over the polyp. In other cases, stratified squamous epithelium develops within the glands themselves through the hyperplasia of reserve cells, followed by the differentiation of solid stratified cell sheets into stratified squamous epithelium.

Adenomatous polyps characterized by the proliferation of stratified squamous epithelium are referred to as epidermizing polyps.