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Adenocarcinoma of the uterine cervix (view source)
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'''Adenocarcinoma of the uterine cervix''' is a relative uncommon form of cervical [[cancer]]. Like the more common [[squamous cell carcinoma of the cervix]], it is associated strongly with the [[human papilloma virus]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Cervical_adenocarcinoma_-_high_mag.jpg | |||
| Width = | |||
| Caption = Cervical adenocarcinoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[microglandular hyperplasia]], [[endocervical adenocarcinoma in situ]], metastatic [[adenocarcinoma]] (e.g. [[endometrioid endometrial carcinoma]], [[serous endometrial carcinoma]], [[colorectal adenocarcinoma]]), [[villoglandular adenocarcinoma]], [[glassy cell carcinoma]], [[clear cell carcinoma]] of the cervix | |||
| Stains = | |||
| IHC = p16 +ve, CEA +ve, vimentin -ve, ER -ve, PR -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[uterine cervix]] - endocervical canal | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = fairly good | |||
| Other = | |||
| ClinDDx = other cervical tumours | |||
| Tx = radical trachelectomy or radical hysterectomy | |||
}} | |||
'''Adenocarcinoma of the uterine cervix''' is a relative uncommon form of cervical [[cancer]]. Like the more common [[squamous cell carcinoma of the uterine cervix|squamous cell carcinoma]], it is associated strongly with the [[human papilloma virus]]. | |||
It is also known as '''endocervical adenocarcinoma''' and '''cervical adenocarcinoma'''. | It is also known as '''endocervical adenocarcinoma''' and '''cervical adenocarcinoma'''. | ||
Very well-differentiated adenocarcinoma of the cervix is covered in ''[[minimal deviation adenocarcinoma of the uterine cervix]]''. | |||
==General== | ==General== | ||
*Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | *Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | ||
*Arises from the endocervical glands. | *Arises from the endocervical glands. | ||
*Usually [[HPV]] related. | |||
*Non-HPV related adenocarcinoma may be syndromic - [[Peutz-Jeghers syndrome]], [[Li-Fraumeni syndrome]].<ref name=pmid26457350>{{Cite journal | last1 = Karamurzin | first1 = YS. | last2 = Kiyokawa | first2 = T. | last3 = Parkash | first3 = V. | last4 = Jotwani | first4 = AR. | last5 = Patel | first5 = P. | last6 = Pike | first6 = MC. | last7 = Soslow | first7 = RA. | last8 = Park | first8 = KJ. | title = Gastric-type Endocervical Adenocarcinoma: An Aggressive Tumor With Unusual Metastatic Patterns and Poor Prognosis. | journal = Am J Surg Pathol | volume = 39 | issue = 11 | pages = 1449-57 | month = Nov | year = 2015 | doi = 10.1097/PAS.0000000000000532 | PMID = 26457350 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Cells with moderate cytoplasm, typically with basally stratfied nuclei. | |||
*Cytologic changes: | |||
**Nuclear hyperchromasia. | |||
**Nuclear pseudostratification. | |||
**Nuclear enlargement. | |||
*Stromal changes - "[[desmoplastic stroma]]/[[desmoplastic reaction]]". | *Stromal changes - "[[desmoplastic stroma]]/[[desmoplastic reaction]]". | ||
**Fibrosis/streaming cells. | **Fibrosis/streaming cells. | ||
*Gland fusion. | *Abnormal architecture: | ||
*Glands too deep -- very fuzzy criterion. | **Gland fusion. | ||
**Glands too deep -- very fuzzy criterion. | |||
Notes: | Notes: | ||
| Line 34: | Line 75: | ||
Image:Cervical_adenocarcinoma_-_intermed_mag.jpg | Cervical adenocarcinoma - intermed. mag. (WC) | Image:Cervical_adenocarcinoma_-_intermed_mag.jpg | Cervical adenocarcinoma - intermed. mag. (WC) | ||
Image:Cervical_adenocarcinoma_-_high_mag.jpg | Cervical adenocarcinoma - high mag. (WC) | Image:Cervical_adenocarcinoma_-_high_mag.jpg | Cervical adenocarcinoma - high mag. (WC) | ||
</gallery> | |||
<gallery> | |||
Image: Endocervical_adenocarcinoma_(1).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(2).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(3).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(4).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
</gallery> | </gallery> | ||
| Line 39: | Line 86: | ||
Features for diagnosis: | Features for diagnosis: | ||
*p16 +ve. | *p16 +ve. | ||
**May be negative ~25% of cases in one series.<ref name=pmid23626605>{{Cite journal | last1 = Izadi-Mood | first1 = N. | last2 = Asadi | first2 = K. | last3 = Shojaei | first3 = H. | last4 = Sarmadi | first4 = S. | last5 = Ahmadi | first5 = SA. | last6 = Sani | first6 = S. | last7 = Chelavi | first7 = LH. | title = Potential diagnostic value of P16 expression in premalignant and malignant cervical lesions. | journal = J Res Med Sci | volume = 17 | issue = 5 | pages = 428-33 | month = May | year = 2012 | doi = | PMID = 23626605 }}</ref> | |||
*Ki-67 -- high. | *Ki-67 -- high. | ||
Uterus vs. cervix:<ref> | Uterus vs. cervix:<ref name=pmid20335127>{{Cite journal | last1 = Hu | first1 = WW. | last2 = Tao | first2 = JH. | last3 = Li | first3 = GM. | last4 = Xu | first4 = X. | last5 = Yang | first5 = XM. | title = [Value of ER, VIM, CEA and p16 detection in the diagnosis and differential diagnosis of primary endocervical and endometrial adenocarcinomas]. | journal = Nan Fang Yi Ke Da Xue Xue Bao | volume = 30 | issue = 3 | pages = 526-8, 531 | month = Mar | year = 2010 | doi = | PMID = 20335127 }}</ref> | ||
*Cervix (typically): CEA +ve, p16 +ve. | *Cervix (typically): CEA +ve, p16 +ve. | ||
**ER -ve, PR -ve, vimentin -ve. | **[[ER]] -ve, PR -ve, vimentin -ve. | ||
*Uterus (typically): vimentin +ve, ER +ve, PR +ve. | *Uterus (typically): vimentin +ve, ER +ve, PR +ve. | ||
**CEA -ve, p16 -ve. | **CEA -ve, p16 -ve. | ||