Morphological spectrum of non-neoplastic lesions of the uterine cervix in Warri, South-South, Nigeria

Abstract

The uterine cervix is a gateway to several non-neoplastic and neoplastic gynecological lesions. Most of these non-neoplastic lesions are commonly found in women of reproductive age. These lesions constitute a source of morbidity and mortality in women worldwide hence the need to analyze them to provide a baseline data of the pattern of these lesions in our local environment. The purpose of this study is to determine the frequency and morphological patterns of non-neoplastic cervical lesions at the central hospital, Warri, Nigeria. All uterine cervical biopsies received at the Department of Pathology, Central Hospital, Warri over a 7 year period (January 2005-December 2011) were the specimens for this study. Slides were retrieved from the archives of the Department of Pathology. Where necessary, new sections were made from formalin fixed, paraffin embedded blocks. A total of 176 cervical specimens were received in the Pathology Department during this period. Of these, 56.3% were benign lesions while 43.7% were malignant. Among the benign cases, non-neoplastic lesions accounted for 92.9% of benign cervical lesions. The age range of non-neoplastic cervical lesions was 20 to 89 years with a mean age of 54.9 ± 4.6 years. The peak age incidence of non-neoplastic cervical lesion was 40-49 years which accounted for 33.7%. Inflammatory lesions and tumor-like lesions accounted for 59.8% and 40.2% of non-neoplastic cervical lesions respectively. Among the inflammatory lesions, chronic non-specific cervicitis was the most commonly encountered lesion constituting 72.2% of all inflammation. Human papilloma virus (HPV) cervicitis with koilocytic changes accounted for 14.5% of all inflammatory lesions. Inflammatory lesions were the most frequent non-neoplastic cervical lesions. These lesions therefore account for significant amount of gynecological problems in our environment. Adequate cervical screening with follow up histological biopsies is a relevant tool in diagnosing them to enhance early detection of premalignant and malignant cervical lesions.