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Endocervical adenocarcinoma in situ (view source)
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# | :''For the cytology see [[Gynecologic cytopathology#Endocervical adenocarcinoma in situ|Endocervical adenocarcinoma in situ (cytology)]]'' | ||
'''Endocervical adenocarcinoma in situ''', also '''adenocarcinoma in situ of the uterine endocervix''', is pre-invasive change of the [[uterine cervix|uterine endocervix]]. It is closely tied to [[HPV]] infection. | |||
If the context is clear, it may be referred to as '''[[adenocarcinoma in situ]]''', abbreviated '''AIS'''. | |||
==General== | |||
*Usually due to [[HPV]]. | |||
*May be found together with squamous neoplasias of the cervix. | |||
*AIS of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | |||
*Generally, definitely diagnosed with an ''endocervical curettage'' (ECC). | |||
==Gross== | |||
*Not apparent at colposcopy. | |||
==Microscopic== | |||
Features:<ref name=pmid10757337>{{Cite journal | last1 = Zaino | first1 = RJ. | title = Glandular lesions of the uterine cervix. | journal = Mod Pathol | volume = 13 | issue = 3 | pages = 261-74 | month = Mar | year = 2000 | doi = 10.1038/modpathol.3880047 | PMID = 10757337 | url = http://www.nature.com/modpathol/journal/v13/n3/full/3880047a.html }}</ref> | |||
#Nuclear changes - '''key feature''': | |||
#*Variable nuclear stratification. | |||
#**Nuclear crowding/pseudostratification. | |||
#*Nuclear enlargement. | |||
#**Often cigar-shaped nuclei. | |||
#*Coarse chromatin. | |||
#*Small nucleolus or [[nucleoli]]. | |||
#+/-Mitoses. | |||
#+/-Reduced cytoplasmic mucin. | |||
#Preservation of glandular architecture. | |||
#*Normal gland spacing - lack of complexity ("lobular pattern"). | |||
#*Normal gland depth (subjective). | |||
DDx: | |||
*[[Tubal metaplasia of the uterine cervix|Tubal metaplasia]]. | |||
*[[Arias-Stella reaction]]. | |||
*[[Endometriosis]]. | |||
*Lower uterine segment epithelium<ref name=Ref_GP167>{{Ref GP|167}}</ref> - esp. [[proliferative phase endometrium]] - mitoses rare, NC ratio normal, stroma different. | |||
*[[Endocervical adenocarcinoma]] - often has paradoxical maturation... paler cytoplasm & nuclei than adjacent AIS. | |||
*[[metastasis|Metastatic]] adenocarcinoma. | |||
*[[Proliferative phase endometrium]] - endometrial type stroma, cytoplasm not pale staining, no nuclear atypia (smooth nuclear contour, stratified). | |||
===Images=== | |||
*[http://www.flickriver.com/photos/euthman/tags/cervix/ Endocervical AIS adjacent to normal (flickriver.com/euthman)]. | |||
*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)]. | |||
*[http://womenshealthsection.com/content/gynpc/gynpc006d.jpg Endocervical adenocarcinoma in situ (womenshealthsection.com)].<ref>URL: [http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english]. Accessed on: 20 March 2013.</ref> | |||
*[http://nih.techriver.net/view.php?patientId=67 Endocervical adenocarcinoma in situ - cytology (techriver.net)]. | |||
==IHC== | |||
*p16 +ve. | |||
*CEA +ve. | |||
*Vimentin -ve. | |||
==See also== | |||
*[[Endocervical adenocarcinoma]]. | |||
*[[Uterine cervix]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Uterine cervix]] | |||