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Difference between revisions of "Uterine cervix"
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[[Cytopathology]] of the cervix is dealt with in the ''[[gynecologic cytopathology]]'' article. | [[Cytopathology]] of the cervix is dealt with in the ''[[gynecologic cytopathology]]'' article. | ||
=Introduction= | |||
*Consists of non-keratinized squamous epithelium and simple columnar epithelium. | *Consists of non-keratinized squamous epithelium and simple columnar epithelium. | ||
*The area of overlap (between squamous & columnar) is known as the "transformation zone".<ref>URL: [http://www.med-ed.virginia.edu/Courses/path/gyn/cervix1.cfm http://www.med-ed.virginia.edu/Courses/path/gyn/cervix1.cfm]. Accessed on: 12 May 2010.</ref> | *The area of overlap (between squamous & columnar) is known as the "transformation zone".<ref>URL: [http://www.med-ed.virginia.edu/Courses/path/gyn/cervix1.cfm http://www.med-ed.virginia.edu/Courses/path/gyn/cervix1.cfm]. Accessed on: 12 May 2010.</ref> | ||
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*Most cervix cancer is squamous cell carcinoma. | *Most cervix cancer is squamous cell carcinoma. | ||
== | =Normal histology= | ||
===Nabothian cyst== | ==Endocervical glands== | ||
Cervical glands normally have round nuclei and vaguely resemble the colonic mucosa. | |||
*If the nuclei are columnar think cancer! This is like in the colon-- columnar nuclei = badness. | |||
Memory device: The Cs (Cervix & Colon) are similar. | |||
=Where to start= | |||
#Identify epithelium - exocervical (stratified squamous), endocervical (simple columnar), both. | |||
#*If there is both exocervix and endocervix --> transition zone. | |||
#Identify possible squamous lesions. | |||
#Identify possible endocervical lesions. | |||
=Benign (common)= | |||
==Nabothian cyst== | |||
Features: | |||
*Simple endocervical cyst. | *Simple endocervical cyst. | ||
**Lined by endocervical epithelial cells. | **Lined by endocervical epithelial cells. | ||
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*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=4&cat2=23&cat3=130&cat4=5&stype=n Nabothian cyst (gfmer.ch)]. | *[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=4&cat2=23&cat3=130&cat4=5&stype=n Nabothian cyst (gfmer.ch)]. | ||
==Tunnel cluster== | |||
*Benign proliferation of endocervical glands<ref>[http://pathologyoutlines.com/cervix.html#tunnelclusters http://pathologyoutlines.com/cervix.html#tunnelclusters]</ref> | Features: | ||
*Benign proliferation of endocervical glands.<ref>URL: [http://pathologyoutlines.com/cervix.html#tunnelclusters http://pathologyoutlines.com/cervix.html#tunnelclusters]. Accessed on: 27 February 2011.</ref> | |||
Notes: | |||
*Important only as one could mistake minimal deviation adenocarcinoma for it. (???) | *Important only as one could mistake minimal deviation adenocarcinoma for it. (???) | ||
= | =Non-invasive= | ||
==Cervical intraepithelial neoplasia (CIN)== | ==Cervical intraepithelial neoplasia (CIN)== | ||
Refers to changes in squamous epithelium. | Refers to changes in squamous epithelium. | ||
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# Benign cells have a small nucleus that is peripheral. | # Benign cells have a small nucleus that is peripheral. | ||
=Cancer= | |||
==Cervix cancer grading== | ==Cervix cancer grading== | ||
#Well-differentiated (keratinizing). | #Well-differentiated (keratinizing). | ||
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#Poorly differentiated. | #Poorly differentiated. | ||
Ref.:<ref>{{Ref PBoD|1077}}</ref> | Ref.:<ref>{{Ref PBoD|1077}}</ref> | ||
==Squamous cell carcinoma (SCC)== | |||
{{Main|Squamous cell carcinoma}} | |||
The most common type of cervical cancer. | |||
===SCC of the cervix versus CIN III=== | ===SCC of the cervix versus CIN III=== | ||
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** ... and CEA-, p16-. | ** ... and CEA-, p16-. | ||
=Uncommon types of cervical cancer= | |||
There are a number of uncommon type of cervical cancer. | There are a number of uncommon type of cervical cancer. | ||
==Adenosquamous carcinoma== | |||
Features: | |||
*Morphologic features of both squamous carcinoma and adenocarcinoma: | |||
**Adenocarcinoma: gland forming ''or'' mucin vacuoles. | |||
**[[Squamous carcinoma]]: abundant eosinophilic cytoplasm, central nucleus. | |||
Image: [http://commons.wikimedia.org/wiki/File:Adenosquamous_carcinoma_high_mag.jpg Adenosquamous carcinoma (WC)]. | Image: [http://commons.wikimedia.org/wiki/File:Adenosquamous_carcinoma_high_mag.jpg Adenosquamous carcinoma - high mag. (WC)]. | ||
==Clear cell carcinoma== | |||
Associated with ''diethylstilbestrol'' exposure ''in utero''.<ref name=pmid19857300>{{Cite journal | last1 = van Dijck | first1 = JA. | last2 = Doorduijn | first2 = Y. | last3 = Bulten | first3 = JH. | last4 = Verloop | first4 = J. | last5 = Massuger | first5 = LF. | last6 = Kiemeney | first6 = BA. | title = [Vaginal and cervical cancer due to diethylstilbestrol (DES); end epidemic] | journal = Ned Tijdschr Geneeskd | volume = 153 | issue = | pages = A366 | month = | year = 2009 | doi = | PMID = 19857300 }}</ref> | Associated with ''diethylstilbestrol'' exposure ''in utero''.<ref name=pmid19857300>{{Cite journal | last1 = van Dijck | first1 = JA. | last2 = Doorduijn | first2 = Y. | last3 = Bulten | first3 = JH. | last4 = Verloop | first4 = J. | last5 = Massuger | first5 = LF. | last6 = Kiemeney | first6 = BA. | title = [Vaginal and cervical cancer due to diethylstilbestrol (DES); end epidemic] | journal = Ned Tijdschr Geneeskd | volume = 153 | issue = | pages = A366 | month = | year = 2009 | doi = | PMID = 19857300 }}</ref> | ||
==Adenoid basal carcinoma== | |||
===General=== | |||
*Good prognosis.<ref name=pmid9438010>{{cite journal |author=Senzaki H, Osaki T, Uemura Y, ''et al.'' |title=Adenoid basal carcinoma of the uterine cervix: immunohistochemical study and literature review |journal=Jpn. J. Clin. Oncol. |volume=27 |issue=6 |pages=437–41 |year=1997 |month=December |pmid=9438010 |doi= |url=http://jjco.oxfordjournals.org/cgi/content/full/27/6/437}}</ref> | *Good prognosis.<ref name=pmid9438010>{{cite journal |author=Senzaki H, Osaki T, Uemura Y, ''et al.'' |title=Adenoid basal carcinoma of the uterine cervix: immunohistochemical study and literature review |journal=Jpn. J. Clin. Oncol. |volume=27 |issue=6 |pages=437–41 |year=1997 |month=December |pmid=9438010 |doi= |url=http://jjco.oxfordjournals.org/cgi/content/full/27/6/437}}</ref> | ||
===Microscopic=== | |||
Features:<ref name=pmid9438010>{{cite journal |author=Senzaki H, Osaki T, Uemura Y, ''et al.'' |title=Adenoid basal carcinoma of the uterine cervix: immunohistochemical study and literature review |journal=Jpn. J. Clin. Oncol. |volume=27 |issue=6 |pages=437–41 |year=1997 |month=December |pmid=9438010 |doi= |url=http://jjco.oxfordjournals.org/cgi/content/full/27/6/437}}</ref> | Features:<ref name=pmid9438010>{{cite journal |author=Senzaki H, Osaki T, Uemura Y, ''et al.'' |title=Adenoid basal carcinoma of the uterine cervix: immunohistochemical study and literature review |journal=Jpn. J. Clin. Oncol. |volume=27 |issue=6 |pages=437–41 |year=1997 |month=December |pmid=9438010 |doi= |url=http://jjco.oxfordjournals.org/cgi/content/full/27/6/437}}</ref> | ||
*Nests of cells with basaloid rim and squamoid center. | *Nests of cells with basaloid rim and squamoid center. | ||
**Basaloid cells look benign. | **Basaloid cells look benign. | ||
=See also= | |||
*[[Vulvar intraepithelial neoplasia]]. | *[[Vulvar intraepithelial neoplasia]]. | ||
*[[Cervical polyp]]. | *[[Cervical polyp]]. | ||
*[[Gynecologic cytopathology]]. | *[[Gynecologic cytopathology]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gynecologic pathology]] | [[Category:Gynecologic pathology]] | ||