Uterine cervix with atrophic changes

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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.

Sign out

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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