Squamous cell carcinoma of the uterine cervix

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Squamous cell carcinoma of the uterine cervix, also cervical squamous cell carcinoma, is the most common primary malignancy of the uterine cervix.

General

  • Most common type of cervical cancer.

Risk factors:

  • Low socioeconomic status.
  • Smoking.
  • Early first intercourse.
  • High risk partners.
  • Human papillomavirus (HPV) infection, esp. "high risk HPV".
    • HPV 16 closely assoc. with SCC.[1]

Gross

  • White lesion.
  • Firm.

Images

  • SCC of cervix. (WC)

Microscopic

Features:

  • Squamous differentiation.
    • +/-Intracellular bridges.
    • Scant-to-moderate cytoplasm.
  • Penetration of basement membrane.
    • May be challenging to determine.
  • Nuclear atypia.

SCC of the cervix versus CIN III: Invasive cancer look for:

  • Eosinophilia.
  • Extra large nuclei, i.e. nuclei 5x normal size.
  • Stromal inflammation (lymphocytes, plasma cells).
  • Long rete ridges.
  • Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges.
  • Desmoplastic stroma - increased cellularity, spindle cell morphology.

DDx:

Images

  • SCC in situ. (WC)

www:

Grading

Divided into:[5]

  1. Well-differentiated (keratinizing).
  2. Moderately differentiated (nonkeratinizing).
  3. Poorly differentiated.

Depth measurement

  • Basement membrane (where it invades) to deepest point.

Note:

  • Stage Ib - clinical diagnosis.
    • Definition of stage Ib: clinically visible.

FIGO

Microinvasive SCC as per FIGO:

  • Depth < 5 mm.
  • Width < 7 mm.
  • +/-Vascular invasion.

SGO

Microinvasive SCC as per The Society of Gynecologic Oncologists (SGO):

Note:

  • The SGO criteria the prefered by North American gynecologists.

IHC

  • Factor VIII - to look for LVI.

Sign out

Early invasive SCC - things to report:

  • Depth of invasion.
  • Length of tumour.
  • Number of blocks with tumour.
  • LVI.
  • Margins.
UTERINE CERVIX, BIOPSY:
- FRAGMENTS OF INVASIVE SQUAMOUS CELL CARCINOMA.
-- DEPTH OF INVASION AND LENTH OF TUMOUR CANNOT BE ASSESSED.
-- LYMPHOVASCULAR INVASION NOT APPARENT.

See also

References

  1. ↑ De Boer, MA.; Peters, LA.; Aziz, MF.; Siregar, B.; Cornain, S.; Vrede, MA.; Jordanova, ES.; Fleuren, GJ. (Apr 2005). "Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries.". Int J Cancer 114 (3): 422-5. doi:10.1002/ijc.20727. PMID 15551313.
  2. ↑ http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf
  3. ↑ 3.0 3.1 URL: http://sunnybrook.ca/content/?page=dept-labs-apath-gynpath-imgat-cvx-mal-microiscc. Accessed on: 2 May 2013.
  4. ↑ URL: http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/homepage.htm. Accessed on: 2 May 2013.
  5. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1077. ISBN 0-7216-0187-1.
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