|
|
Line 658: |
Line 658: |
| *[[AKA]] ''endocervical adenocarcinoma''. | | *[[AKA]] ''endocervical adenocarcinoma''. |
| *[[AKA]] ''cervical adenocarcinoma''. | | *[[AKA]] ''cervical adenocarcinoma''. |
| ===General===
| | {{Main|Adenocarcinoma of the uterine cervix}} |
| *Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix.
| |
| *Arises from the endocervical glands.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *Stromal changes - "[[desmoplastic stroma]]/[[desmoplastic reaction]]".
| |
| **Fibrosis/streaming cells.
| |
| *Gland fusion.
| |
| *Glands too deep -- very fuzzy criterion.
| |
| | |
| Notes:
| |
| *AIS changes - similar to [[colon|colonic]] dysplasia.
| |
| *AIS may occur together with CIN.
| |
| **Not infrequently they (AIS, CIN) occur together - both are due, indirectly, to HPV infection.
| |
| *May be difficult to be certain of invasion.
| |
| **A feature suggestive of invasion is ''cytoplasmic eosinophilia''.
| |
| | |
| DDx:
| |
| *[[Microglandular hyperplasia]] - [[NC ratio]] normal, no nuclear atypia.
| |
| *[[Endocervical adenocarcinoma in situ]].
| |
| *Metastatic adenocarcinoma.
| |
| | |
| Images:
| |
| *[http://commons.wikimedia.org/wiki/File:Cervical_adenocarcinoma_-_low_mag.jpg Cervical adenocarcinoma - low mag. (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:Cervical_adenocarcinoma_-_intermed_mag.jpg Cervical adenocarcinoma - intermed. mag. (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:Cervical_adenocarcinoma_-_high_mag.jpg Cervical adenocarcinoma - high mag. (WC)].
| |
| | |
| ===IHC===
| |
| Features for diagnosis:
| |
| *p16 +ve.
| |
| *Ki-67 -- high.
| |
| | |
| Uterus vs. cervix:<ref>LAE. 15 January 2009.</ref>
| |
| *Cervix (typically): CEA +ve, p16 +ve.
| |
| **ER -ve, PR -ve, vimentin -ve.
| |
| *Uterus (typically): vimentin +ve, ER +ve, PR +ve.
| |
| **CEA -ve, p16 -ve.
| |
|
| |
|
| =Uncommon non-invasive= | | =Uncommon non-invasive= |