Precise clinical differentiation between lobular endocervical hyperplasia (LEGH) and mucinous carcinoma, including the gastric type, in women with multi-cystic lesions in the uterine cervix is important. However, tissue sampling is difficult when the lesions are located near the internal os. We report the effectiveness of hysteroscopic transcervical resection (TCR) in the diagnosis of LEGH located at the internal os. A 35-year-old Japanese woman with clinical LEGH was followed-up at our hospital. After 3 years of follow-up, she required pathological examination because the lesion increased in size, which suggested malignant transformation. We performed TCR for biopsy because the LEGH lesion was located at the internal os and conization biopsy was considered difficult. Hysteroscopic observation revealed a blue bulging area in the post cervical wall near the internal os, and tissue samples were taken from the lesion by TCR. Pathologically, lobular proliferation of cervical glands with positive HIK1083 and PAS reactions was observed, confirming the diagnosis of LEGH. Cervical biopsy using TCR may be effective for the pathological diagnosis of LEGH located near the internal os.
