3.2.2: Endocervical Polyp
- Page ID
- 98252
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Polyps are abnormal growths that arise from the ecto or endocervix. They are usually benign (common in reproductive age) and, rarely, malignant. Malignant polyps are seen mainly in postmenopausal women.
They vary in shape, size, number (single or multiple), and color (degree of vascularization). Endocervical polyps are more common than ectocervical ones and occur in premenopausal women, while ectocervical polyps are more common in postmenopausal women.29
3.2.2.2 Etiology
The exact etiology is unknown. However, vascular congestion, infections, chronic inflammations, chemical irritants, and hormonal imbalances are hypothesized causes. Risk factors include premenopausal, multigravida, and STI.30
3.2.2.3 Histopathology
Microscopically, cervical polyps have a vascular connective tissue core covered by proliferating epithelial cells. Endocervical polyps (Figure 3.2.1) are the most common type and have loose, edematous stroma with variably sized blood vessels. Chronic inflammatory infiltrate can be detected in the stroma. Epithelial cells demonstrate glandular hyperplasia.31
3.2.2.4 Clinical Picture
Cervical polyps are incidentally detected during routine gynecological examination. They can be asymptomatic or present with abnormal uterine bleeding, including heavy menstruation, intermenstrual bleeding, or postmenopausal bleeding. Other presentations include vaginal discharge and infertility (if polyps are large enough to block the cervical canal). Histologic examination of cervical polyps is essential for the diagnosis of underlying and associated pathologies and to rule out malignancy.32
3.2.2.5 Treatment
Usually, asymptomatic polyps don't need any intervention. Large symptomatic polyps require removal (i.e., polypectomy) using forceps, electrosurgical excision, or laser ablation.33
Figure 3.2.1 Endocervical polyp: With endocervical epithelium and glands (mucinous columnar linings), edematous stroma, and clear congestion. H&E stain.
Image Source: Aggarwal, Pearl and Anissa Ben Amor. "Cervical Ectropion," StatPearls (2024). This work is distributed under a CC BY-NC-ND license. Available from NIH National Library of Medicine (NLM) Bookshelf StatPearls.
Glossary Terms
- Ablation
- removal or destruction of a body part or tissue or its function; may be performed by surgery, hormones, drugs, radiofrequency, heat, or other methods
- Benign
- non-cancerous
- Ectocervix
- outer part of the neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal
- Edematous
- ccc
- Endocervix
- inner part of the neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal
- Epithelial
- relating to or affected with edema : abnormally swollen with fluid
- Histology
- The study of tissues
- Hyperplasia
- abnormal growth due to the production of cells
- Malignant
- cancerous
- Multigravida
- a woman who has been pregnant more than once
- Stroma
- tissue that forms the structure of an organ or body part
- Vascularization
- process of becoming vascular (channel for the conveyance of a body fluid (such as blood)
Footnotes
- Alkilani, Yara G. and Irasema Apodaca-Ramos. “Cervical Polyps.” The American Journal of Surgery 36, no. 1 (September 4, 2023): 239. doi.org/10.1016/S0002-9610(37)90821-3.
- Alkilani and Apodaca-Ramos, 2023
- Alkilani and Apodaca-Ramos, 2023
- Alkilani and Apodaca-Ramos, 2023
- Alkilani and Apodaca-Ramos, 2023
Image Acknowledgements
Aggarwal, Pearl and Anissa Ben Amor. "Cervical Ectropion," StatPearls (2024). This work is distributed under a CC BY-NC-ND license. Available from NIH National Library of Medicine (NLM) Bookshelf StatPearls.