Pseudoneoplastic lesions of the uterine cervix

The differential diagnosis of malignant and premalignant lesions of the uterine cervix includes numerous non-neoplastic conditions which may show overlapping morphological features. Recognizing these mimics is crucial in order to spare the patient unnecessary surgical procedures with potential side effects, as well as the psychosocial consequences associated with the diagnosis of HPV-infection and/or (pre)malignancy. This article reviews benign entities that may be mistaken for neoplastic lesions of the cervix. Conditions of the ectocervical squamous epithelium, the endocervical glandular epithelium and the cervical stroma are systematically discussed in the context of the respective (pre)malignant lesion that they may be confused with, including low and high-grade squamous intraepithelial lesions, invasive squamous cell carcinoma, adenocarcinoma in-situ, various types of invasive adenocarcinomas, and sarcomas. Emphasis is placed on those features that help distinguish pseudoneoplastic lesions from true neoplasms, including clinical information, morphologic findings and ancillary studies.