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 is relatively common and is important to recognize as it can mimic HSIL.

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

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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