(wolffian) remnants are the vestigial elements of the
mesonephric ducts. In men, the mesonephric ducts develop into the
efferent ducts of the testis, epididymis, vasa deferentia, seminal
vesicles, and ejaculatory ducts. In women, the ducts usually regress
but can persist as remnants in the broad ligament, cervix, and
vagina. Mesonephric remnants are present in up to 22% of cervices,
usually in the lateral wall.
consist of small cysts and/or tubules lined by bland cuboidal or low
columnar nonciliated epithelium. The cytoplasm may appear clear or
eosinophilic but does not contain cytoplasmic mucin (in
contrast to endocervical epithelium) or glycogen.
Characteristically, a densely eosinophilic, PAS-positive, luminal
secretion is present.
hyperplasia has been divided into three categories:
mesonephric hyperplasia: proliferation of loosely organized,
variably sized, mesonephric tubules predominantly arranged in
mesonephric hyperplasia: no lobular pattern is apparent. The
diffuse form of mesonephric hyperplasia
thus may be the most diagnostically challenging, because it
appears less organized and can extend deeply into the
cervical wall, mimicking a well-differentiated adenocarcinoma.
ductal hyperplasia: the least common subtype of the mesonephric
hyperplasia, characterized by a prominent duct lined by
hyperplastic appearing epithelium with papillary tufting,
diagnosis of mesonephric hyperplasia
carcinoma: exceedingly rare, may co-existent with mesonephric
hyperplasia. Mesonephric carcinoma is usually associated with a
visible gross abnormality.Mesonephric carcinoma exhibits a
greater degree of glandular crowding (“back-to-back” glandular
growth), an irregular, disorderly growth pattern, greater
nuclear atypia, prominent mitotic activity, and often an
associated stromal reaction.
adenocarcinoma: more irregularly shaped and sized glands that
are lined by mucinous epithelium. Desmoplastic stromal response,
nuclear atypia, and mitotic activity.
carcinoma, tubulocystic variant: the cells lining the tubules in
mesonephric hyperplasia are bland and lack the abundant
glycogen-rich clear cytoplasm. clear-cell carcinoma has more
prominent nuclear atypia. In addition, areas of solid growth and
hobnail cells, features typical of clear-cell carcinoma, are not
seen in mesonephric hyperplasia.