title: Microglandular hyperplasia: a model for the de novo emergence and evolution of endocervical reserve cells.
abstract: BACKGROUND
  Microglandular hyperplasia (MGH) of the cervix in human beings is associated early with gland proliferation and terminates in mature squamous metaplasia. Using antibodies to basal cell markers, we analyzed biopsies with MGH to profile the distribution and evolution of reserve cells and their relationship to these epithelial components.
  
  
  METHODS
  Serial sections of 24 MGHs were subdivided into (1) early MGH with microacinar proliferation, abundant subnuclear vacuoles, and a paucity of supporting stroma and (2) late MGH with more prominent supporting stroma and/or squamous metaplasia. Serial sections were stained with antibodies to p63, bcl-2, and keratin-5.
  
  
  RESULTS
  Three patterns of p63 staining were observed corresponding to the age of the MGH: (1) scattered staining of columnar cells, (2) focal subcolumnar staining in a reserve cell distribution, and (3) linear subcolumnar arrays of p63-positive reserve cells that in some MGHs expanded into a squamous metaplasia. Early acinar proliferations showed weak and focal columnar cell staining followed by focal subcolumnar p63-positive cells. In late lesions, p63 staining was compartmentalized to the extraglandular (or subcolumnar) areas. Stainings of p63, bcl-2, and keratin-5 were concordant. Staining for keratin 14, which localizes to squamous cells, was variable.
  
  
  CONCLUSIONS
  The immunohistochemical profile in MGH indicates that reserve cells are created in adulthood during specialized columnar proliferations. This columnar to reserve cell transition may produce a stable population of reserve cells or a transition to squamous metaplasia. Similar patterns are seen in cervical neoplasia, suggesting a link between benign and neoplastic cervical epithelial differentiation.
authors.affiliation: Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Agnieszka K
authors.initials: AK
authors.lastname: Witkiewicz
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Hecht
authors.forename: Aida
authors.initials: A
authors.lastname: Cviko
authors.forename: Frank D
authors.initials: FD
authors.lastname: McKeon
authors.forename: Tan A
authors.initials: TA
authors.lastname: Ince
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Crum
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002471:Cell Transformation, Neoplastic / Q000378:metabolism / Q000473:pathology*; D002584:Cervix Uteri / Q000378:metabolism / Q000473:pathology*; D004714:Endometrial Hyperplasia / Q000378:metabolism / Q000473:pathology*; D004717:Endometrium / Q000378:metabolism / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008679:Metaplasia / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers