A case of extensive transitional cell metaplasia (TCM) and ectopic prostatic tissue was encountered in the uterine cervix and vagina of a 23-year-old woman with the adrenogenital syndrome. A previously described case of ectopic prostatic tissue in the cervix in a patient with female pseudohermaphroditism and our case suggest that prolonged androgen stimulation plays a role in the development of prostatic tissue. Similarly, the occurrence of TCM in the perimenopausal and postmenopausal periods when the ovaries secrete androgens, in female transsexuals treated with androgens, and in our patient with high endogenous androgen levels suggest that androgen has a major role in the histogenesis of TCM. Significantly decreased Ki-67 immunopositivity in TCM compared with the normal cervical mucosa of women in the reproductive age indicates that TCM is a mild form of epithelial atrophy, presumably caused by the neutralizing effect of androgens.
From the Departments of Pathology (K.-R.K., J.-W.K., K.-J.C., J.Y.R.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; and Yonsei University College of Medicine (K.-H.P.), Seoul, Korea.
Address correspondence and reprint requests to Kyu-Rae Kim, M.D., Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 388–1 Pungnap-2-dong, Songpa-gu, Seoul, 138–736, Korea.