Difference between revisions of "Adenocarcinoma of the uterine cervix"
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It is also known as '''endocervical adenocarcinoma''' and '''cervical adenocarcinoma'''. | It is also known as '''endocervical adenocarcinoma''' and '''cervical adenocarcinoma'''. | ||
Very well-differentiated adenocarcinoma of the cervix is covered in ''[[minimal deviation adenocarcinoma of the uterine cervix]]''. | |||
==General== | ==General== | ||
*Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | *Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | ||
*Arises from the endocervical glands. | *Arises from the endocervical glands. | ||
*Usually [[HPV]] related. | |||
*Non-HPV related adenocarcinoma may be syndromic - [[Peutz-Jeghers syndrome]], [[Li-Fraumeni syndrome]].<ref name=pmid26457350>{{Cite journal | last1 = Karamurzin | first1 = YS. | last2 = Kiyokawa | first2 = T. | last3 = Parkash | first3 = V. | last4 = Jotwani | first4 = AR. | last5 = Patel | first5 = P. | last6 = Pike | first6 = MC. | last7 = Soslow | first7 = RA. | last8 = Park | first8 = KJ. | title = Gastric-type Endocervical Adenocarcinoma: An Aggressive Tumor With Unusual Metastatic Patterns and Poor Prognosis. | journal = Am J Surg Pathol | volume = 39 | issue = 11 | pages = 1449-57 | month = Nov | year = 2015 | doi = 10.1097/PAS.0000000000000532 | PMID = 26457350 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
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Image:Cervical_adenocarcinoma_-_intermed_mag.jpg | Cervical adenocarcinoma - intermed. mag. (WC) | Image:Cervical_adenocarcinoma_-_intermed_mag.jpg | Cervical adenocarcinoma - intermed. mag. (WC) | ||
Image:Cervical_adenocarcinoma_-_high_mag.jpg | Cervical adenocarcinoma - high mag. (WC) | Image:Cervical_adenocarcinoma_-_high_mag.jpg | Cervical adenocarcinoma - high mag. (WC) | ||
</gallery> | |||
<gallery> | |||
Image: Endocervical_adenocarcinoma_(1).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(2).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(3).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
Image: Endocervical_adenocarcinoma_(4).jpg | Endocervical adenocarcinoma. (WC/KGH) | |||
</gallery> | </gallery> | ||
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*Ki-67 -- high. | *Ki-67 -- high. | ||
Uterus vs. cervix:<ref> | Uterus vs. cervix:<ref name=pmid20335127>{{Cite journal | last1 = Hu | first1 = WW. | last2 = Tao | first2 = JH. | last3 = Li | first3 = GM. | last4 = Xu | first4 = X. | last5 = Yang | first5 = XM. | title = [Value of ER, VIM, CEA and p16 detection in the diagnosis and differential diagnosis of primary endocervical and endometrial adenocarcinomas]. | journal = Nan Fang Yi Ke Da Xue Xue Bao | volume = 30 | issue = 3 | pages = 526-8, 531 | month = Mar | year = 2010 | doi = | PMID = 20335127 }}</ref> | ||
*Cervix (typically): CEA +ve, p16 +ve. | *Cervix (typically): CEA +ve, p16 +ve. | ||
**ER -ve, PR -ve, vimentin -ve. | **[[ER]] -ve, PR -ve, vimentin -ve. | ||
*Uterus (typically): vimentin +ve, ER +ve, PR +ve. | *Uterus (typically): vimentin +ve, ER +ve, PR +ve. | ||
**CEA -ve, p16 -ve. | **CEA -ve, p16 -ve. |
Latest revision as of 20:34, 23 June 2016
Adenocarcinoma of the uterine cervix is a relative uncommon form of cervical cancer. Like the more common squamous cell carcinoma, it is associated strongly with the human papilloma virus.
Adenocarcinoma of the uterine cervix | |
---|---|
Diagnosis in short | |
Cervical adenocarcinoma. H&E stain. | |
LM DDx | microglandular hyperplasia, endocervical adenocarcinoma in situ, metastatic adenocarcinoma (e.g. endometrioid endometrial carcinoma, serous endometrial carcinoma, colorectal adenocarcinoma), villoglandular adenocarcinoma, glassy cell carcinoma, clear cell carcinoma of the cervix |
IHC | p16 +ve, CEA +ve, vimentin -ve, ER -ve, PR -ve |
Site | uterine cervix - endocervical canal |
| |
Prevalence | uncommon |
Prognosis | fairly good |
Clin. DDx | other cervical tumours |
Treatment | radical trachelectomy or radical hysterectomy |
It is also known as endocervical adenocarcinoma and cervical adenocarcinoma.
Very well-differentiated adenocarcinoma of the cervix is covered in minimal deviation adenocarcinoma of the uterine cervix.
General
- Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix.
- Arises from the endocervical glands.
- Usually HPV related.
- Non-HPV related adenocarcinoma may be syndromic - Peutz-Jeghers syndrome, Li-Fraumeni syndrome.[1]
Microscopic
Features:
- Cells with moderate cytoplasm, typically with basally stratfied nuclei.
- Cytologic changes:
- Nuclear hyperchromasia.
- Nuclear pseudostratification.
- Nuclear enlargement.
- Stromal changes - "desmoplastic stroma/desmoplastic reaction".
- Fibrosis/streaming cells.
- Abnormal architecture:
- Gland fusion.
- Glands too deep -- very fuzzy criterion.
Notes:
- AIS changes - similar to 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.
- Villoglandular adenocarcinoma.
- Glassy cell carcinoma.
- Metastatic adenocarcinoma.
Images
IHC
Features for diagnosis:
- p16 +ve.
- May be negative ~25% of cases in one series.[2]
- Ki-67 -- high.
Uterus vs. cervix:[3]
- Cervix (typically): CEA +ve, p16 +ve.
- ER -ve, PR -ve, vimentin -ve.
- Uterus (typically): vimentin +ve, ER +ve, PR +ve.
- CEA -ve, p16 -ve.
See also
References
- ↑ Karamurzin, YS.; Kiyokawa, T.; Parkash, V.; Jotwani, AR.; Patel, P.; Pike, MC.; Soslow, RA.; Park, KJ. (Nov 2015). "Gastric-type Endocervical Adenocarcinoma: An Aggressive Tumor With Unusual Metastatic Patterns and Poor Prognosis.". Am J Surg Pathol 39 (11): 1449-57. doi:10.1097/PAS.0000000000000532. PMID 26457350.
- ↑ Izadi-Mood, N.; Asadi, K.; Shojaei, H.; Sarmadi, S.; Ahmadi, SA.; Sani, S.; Chelavi, LH. (May 2012). "Potential diagnostic value of P16 expression in premalignant and malignant cervical lesions.". J Res Med Sci 17 (5): 428-33. PMID 23626605.
- ↑ Hu, WW.; Tao, JH.; Li, GM.; Xu, X.; Yang, XM. (Mar 2010). "[Value of ER, VIM, CEA and p16 detection in the diagnosis and differential diagnosis of primary endocervical and endometrial adenocarcinomas].". Nan Fang Yi Ke Da Xue Xue Bao 30 (3): 526-8, 531. PMID 20335127.