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Squamous cell carcinoma of the uterine cervix (view source)
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'''Squamous cell carcinoma of the uterine cervix''', also '''cervical squamous cell carcinoma''', is the most common primary malignancy of the [[uterine cervix]]. | |||
==General== | |||
*Most common type of cervical cancer. | |||
Risk factors: | |||
*Low socioeconomic status. | |||
*Smoking. | |||
*Early first intercourse. | |||
*High risk partners. | |||
*[[Human papillomavirus]] (HPV) infection, esp. "high risk HPV". | |||
**HPV 16 closely assoc. with SCC.<ref name=pmid15551313>{{Cite journal | last1 = De Boer | first1 = MA. | last2 = Peters | first2 = LA. | last3 = Aziz | first3 = MF. | last4 = Siregar | first4 = B. | last5 = Cornain | first5 = S. | last6 = Vrede | first6 = MA. | last7 = Jordanova | first7 = ES. | last8 = Fleuren | first8 = GJ. | title = Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries. | journal = Int J Cancer | volume = 114 | issue = 3 | pages = 422-5 | month = Apr | year = 2005 | doi = 10.1002/ijc.20727 | PMID = 15551313 }}</ref> | |||
==Microscopic== | |||
Features: | |||
*Squamous differentiation. | |||
**+/-Intracellular bridges. | |||
**Scant-to-moderate cytoplasm. | |||
*Penetration of basement membrane. | |||
**May be challenging to determine. | |||
*Nuclear atypia. | |||
SCC of the cervix versus CIN III: | |||
Invasive cancer look for: | |||
*Eosinophilia. | |||
*Extra large nuclei, i.e. nuclei 5x normal size. | |||
*Stromal inflammation (lymphocytes, plasma cells). | |||
*Long rete ridges. | |||
*Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges. | |||
*[[Desmoplastic stroma]] - increased cellularity, spindle cell morphology. | |||
DDx: | |||
* [[Squamous metaplasia of the uterine cervix]] - if you can trace the squamous cells from a gland to the surface it is less likely to be invasive cancer.<ref>[http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf]</ref> | |||
*[[CIN III]] +/- endocervical gland involvement. | |||
===Images=== | |||
<gallery> | |||
Image:Ca_in_situ,_cervix_2.jpg|SCC in situ. (WC) | |||
</gallery> | |||
www: | |||
*[http://sunnybrook.ca/uploads/cx_microinv_scc_S10-5249_6.jpg Microinvasive cervical SCC - low mag. (sunnybrook.ca)].<ref name=sb_cx_scc/> | |||
*[http://sunnybrook.ca/uploads/cx_microinv_scc_S10-5249_7.jpg Microinvasive cervical SCC - high mag. (sunnybrook.ca)].<ref name=sb_cx_scc>URL: [http://sunnybrook.ca/content/?page=dept-labs-apath-gynpath-imgat-cvx-mal-microiscc http://sunnybrook.ca/content/?page=dept-labs-apath-gynpath-imgat-cvx-mal-microiscc]. Accessed on: 2 May 2013.</ref> | |||
*[http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/ASSETS/Slide329SCClp_small.JPG Cervical SCC - low mag. (ucsf.edu)].<ref name=uscf>URL: [http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/homepage.htm http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/homepage.htm]. Accessed on: 2 May 2013.</ref> | |||
*[http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/ASSETS/Slide329SCChp.JPG Cervical SCC - high mag. (uscf.edu)]. | |||
===Grading=== | |||
Divided into:<ref>{{Ref PBoD|1077}}</ref> | |||
#Well-differentiated (keratinizing). | |||
#Moderately differentiated (nonkeratinizing). | |||
#Poorly differentiated. | |||
===Depth measurement=== | |||
*Basement membrane (where it invades) to deepest point. | |||
Note: | |||
*Stage Ib - clinical diagnosis. | |||
**Definition of stage Ib: clinically visible. | |||
====FIGO==== | |||
Microinvasive SCC as per FIGO: | |||
*Depth < 5 mm. | |||
*Width < 7 mm. | |||
*+/-Vascular invasion. | |||
====SGO==== | |||
Microinvasive SCC as per The Society of Gynecologic Oncologists (SGO): | |||
*<= 3 mm. | |||
*Negative for [[vascular invasion]]. | |||
Note: | |||
*The SGO criteria the prefered by North American gynecologists. | |||
==IHC== | |||
*Factor VIII - to look for [[LVI]]. | |||
==Sign out== | |||
Early invasive SCC - things to report: | |||
*Depth of invasion. | |||
*Length of tumour. | |||
*Number of blocks with tumour. | |||
*LVI. | |||
*Margins. | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- FRAGMENTS OF INVASIVE SQUAMOUS CELL CARCINOMA. | |||
-- DEPTH OF INVASION AND LENTH OF TUMOUR CANNOT BE ASSESSED. | |||
-- LYMPHOVASCULAR INVASION NOT APPARENT. | |||
</pre> | |||
==See also== | |||
*[[Uterine cervix]]. | |||
*[[Squamous cell carcinoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Uterine cervix]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||