Clinical manifestations and ultrasonographic features of lobular endocervical glandular hyperplasia: a retrospective study of 135 patients.

BACKGROUND

Lobular endocervical glandular hyperplasia (LEGH) is a precursor to malignant lesions of the endocervix. However, precise histopathological sampling for early detection remains a challenge. This study aimed to review the clinical features of LEGH and particularly focus on its ultrasonographic characteristics.

PATIENTS: A retrospective analysis was conducted on 135 patients with LEGH (including those with or without concurrent malignancy). Clinical data, preoperative diagnostic evaluations, and histopathological findings were systematically collected and analyzed. Concurrently, we focused on the ultrasonographic features of LEGH.

RESULTS

Symptoms of watery vaginal discharge were clinically documented in 63.0% (85/135) of the patients in this study cohort. Cytological analysis revealed negative results in 88.1% (119/135) of the specimens. Sonographic evaluation identified multicystic cervical lesions or masses and occupation of the uterine cavity in 59.3% (80/135) of cases, whereas magnetic resonance imaging (MRI) demonstrated superior detection capability in 92.9% (104/112) of the examined patients. Sonographic examination showed heterogeneous echogenic areas of various sizes in the upper part of the cervix. The cystic lesions presented with enhanced internal and peripheral echogenicity, and the boundary was not clear. Ultrasonographic images also revealed absent or sparse blood flow signals in LEGH. The detection rate of vaginoscopic biopsy was of 48.5% (33/68).

CONCLUSION

The preoperative diagnostic workup for LEGH requires the integration of clinical manifestations, cervical cytology, sonographic evaluation, and pelvic MRI. Sonographic evaluation demonstrated heterogeneous echogenicity, echogenic enhancement, obscure boundaries, and no significant blood flow signals as the defining features of LEGH.