Difference between revisions of "Uterine cervix with atrophic changes"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      = Atrophic cervix -- very high mag.jpg
| Image      = Atrophic cervix -- very high mag.jpg  
| Width      =
| Width      =
| Caption    = Atrophic cervix. [[H&E stain]].
| Caption    = Atrophic cervix. [[H&E stain]].
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| Micro      = small squamous cells with grey/blue cytoplasm, no "dancing"/"sparkling" chromatin, no mitoses
| Micro      = small squamous cells with grey/blue cytoplasm, no "dancing"/"sparkling" chromatin, no mitoses
| Subtypes  =
| Subtypes  =
| LMDDx      = [[HSIL]]
| LMDDx      = [[HSIL]], immature [[squamous metaplasia of the uterine cervix|squamous metaplasia]]
| Stains    =  
| Stains    =  
| IHC        = p16 -ve, Ki-67 rare basal cells
| IHC        = p16 -ve, Ki-67 rare basal cells
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| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
| Clinicalhx = old
| Clinicalhx = usually postmenopausal
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
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==Microscopic==
==Microscopic==
Features:
Features - squamous cells:
*Cells smaller.
*Cells smaller.
*Cytoplasm grey/blue.
*Cytoplasm grey/blue.
*No "dancing"/"sparkling" chromatin.
*No "dancing"/"sparkling" chromatin.
*No mitoses.
*No mitoses.
Notes: 
*Mitosis do not exclude the diagnosis.... but should make one think HSIL.


DDx:
DDx:
*[[HSIL]].
*[[HSIL]].
*Immature [[squamous metaplasia of the uterine cervix|squamous metaplasia]].<ref name=pmid17824788/>


===Images===
===Images===
<gallery>
<gallery>
Image: Atrophic cervix -- intermed mag.jpg | AC - intermed. mag.
Image: Atrophic cervix -- intermed mag.jpg | AC - intermed. mag. (WC)
Image: Atrophic cervix - alt -- high mag.jpg | AC - high mag.
Image: Atrophic cervix - alt -- high mag.jpg | AC - high mag. (WC)
Image: Atrophic cervix -- high mag.jpg | AC - high mag.
Image: Atrophic cervix -- high mag.jpg | AC - high mag. (WC)
Image: Atrophic cervix -- very high mag.jpg | AC - very high mag.
Image: Atrophic cervix -- very high mag.jpg | AC - very high mag. (WC)
</gallery>
</gallery>
<gallery>
<gallery>
Image: Atrophic cervix - 2 -- intermed mag.jpg | AC - intermed. mag.
Image: Atrophic cervix - 2 -- intermed mag.jpg | AC - intermed. mag. (WC)
Image: Atrophic cervix - 2 -- high mag.jpg | AC - high mag.
Image: Atrophic cervix - 2 -- high mag.jpg | AC - high mag. (WC)
Image: Atrophic cervix - 2 -- very high mag.jpg | AC - very high mag.
Image: Atrophic cervix - 2 -- very high mag.jpg | AC - very high mag. (WC)
</gallery>
</gallery>
www:
www:
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==IHC==
==IHC==
Features:<ref name=pmid17824788>{{Cite journal  | last1 = Iaconis | first1 = L. | last2 = Hyjek | first2 = E. | last3 = Ellenson | first3 = LH. | last4 = Pirog | first4 = EC. | title = p16 and Ki-67 immunostaining in atypical immature squamous metaplasia of the uterine cervix: correlation with human papillomavirus detection. | journal = Arch Pathol Lab Med | volume = 131 | issue = 9 | pages = 1343-9 | month = Sep | year = 2007 | doi = 10.1043/1543-2165(2007)131[1343:PAKIIA]2.0.CO;2 | PMID = 17824788 }}</ref>
*p16 -ve.
*p16 -ve.
*Ki-67 rare basal cells.
*Ki-67 rare basal cells.

Latest revision as of 13:55, 27 June 2015

Uterine cervix with atrophic changes
Diagnosis in short

Atrophic cervix. H&E stain.
LM small squamous cells with grey/blue cytoplasm, no "dancing"/"sparkling" chromatin, no mitoses
LM DDx HSIL, immature squamous metaplasia
IHC p16 -ve, Ki-67 rare basal cells
Site uterine cervix - exocervix
Clinical history usually postmenopausal
Prevalence common
Prognosis benign
Other normal - postmenopausal

Uterine cervix with atrophic changes is relatively common and is important to recognize as it can mimic HSIL.

It is also known as atrophy of the uterine cervix, cervical atrophy, atrophy of the cervix and cervix with atrophic changes.

General

  • Common.
  • Post-menupausal.
  • Important to recognize and differentiate from HSIL.

Microscopic

Features - squamous cells:

  • Cells smaller.
  • Cytoplasm grey/blue.
  • No "dancing"/"sparkling" chromatin.
  • No mitoses.

Notes:

  • Mitosis do not exclude the diagnosis.... but should make one think HSIL.

DDx:

Images

  • AC - intermed. mag. (WC)

  • AC - high mag. (WC)

  • AC - high mag. (WC)

  • AC - very high mag. (WC)

  • AC - intermed. mag. (WC)

  • AC - high mag. (WC)

  • AC - very high mag. (WC)

www:

IHC

Features:[1]

  • p16 -ve.
  • Ki-67 rare basal cells.

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UTERINE CERVIX, BIOPSY:
- SQUAMOUS MUCOSA WITH ATROPHIC CHANGES.
- BENIGN ENDOCERVICAL EPITHELIUM.
- NEGATIVE FOR DYSPLASIA.

COMMENT:
A p16 immunostain is negative. A Ki-67 immunostain marks rare basal cells.

See also

References

  1. ↑ 1.0 1.1 Iaconis, L.; Hyjek, E.; Ellenson, LH.; Pirog, EC. (Sep 2007). "p16 and Ki-67 immunostaining in atypical immature squamous metaplasia of the uterine cervix: correlation with human papillomavirus detection.". Arch Pathol Lab Med 131 (9): 1343-9. doi:10.1043/1543-2165(2007)131[1343:PAKIIA]2.0.CO;2. PMID 17824788.
  2. ↑ URL: http://www.eurocytology.eu/static/eurocytology/TUR/cervical/LP1ContentLcontC.html. Accessed on: 13 December 2013.
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