Difference between revisions of "Uterine cervix"

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Uterine cervix (view source)

Revision as of 13:59, 23 February 2014

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→‎Squamous cell carcinoma of the uterine cervix: split out
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{{Main|Squamous cell carcinoma}}
{{Main|Squamous cell carcinoma}}
*[[AKA]] ''cervical squamous cell carcinoma''.
*[[AKA]] ''cervical squamous cell carcinoma''.
===General===
{{Main|Squamous cell carcinoma of the uterine cervix}}
*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.<ref name=pmid15551313>{{Cite journal  | last1 = De Boer | first1 = MA. | last2 = Peters | first2 = LA. | last3 = Aziz | first3 = MF. | last4 = Siregar | first4 = B. | last5 = Cornain | first5 = S. | last6 = Vrede | first6 = MA. | last7 = Jordanova | first7 = ES. | last8 = Fleuren | first8 = GJ. | title = Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries. | journal = Int J Cancer | volume = 114 | issue = 3 | pages = 422-5 | month = Apr | year = 2005 | doi = 10.1002/ijc.20727 | PMID = 15551313 }}</ref>
 
===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:
* [[Squamous metaplasia of the uterine cervix]] - if you can trace the squamous cells from a gland to the surface it is less likely to be invasive cancer.<ref>[http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf]</ref>
*[[CIN III]] +/- endocervical gland involvement.
 
====Images====
<gallery>
Image:Ca_in_situ,_cervix_2.jpg|SCC in situ. (WC)
</gallery>
www:
*[http://sunnybrook.ca/uploads/cx_microinv_scc_S10-5249_6.jpg Microinvasive cervical SCC - low mag. (sunnybrook.ca)].<ref name=sb_cx_scc/>
*[http://sunnybrook.ca/uploads/cx_microinv_scc_S10-5249_7.jpg Microinvasive cervical SCC - high mag. (sunnybrook.ca)].<ref name=sb_cx_scc>URL: [http://sunnybrook.ca/content/?page=dept-labs-apath-gynpath-imgat-cvx-mal-microiscc http://sunnybrook.ca/content/?page=dept-labs-apath-gynpath-imgat-cvx-mal-microiscc]. Accessed on: 2 May 2013.</ref>
*[http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/ASSETS/Slide329SCClp_small.JPG Cervical SCC - low mag. (ucsf.edu)].<ref name=uscf>URL: [http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/homepage.htm http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/homepage.htm]. Accessed on: 2 May 2013.</ref>
*[http://missinglink.ucsf.edu/lm/IDS_107_Cervix_Ovary_Uterus/ASSETS/Slide329SCChp.JPG Cervical SCC - high mag. (uscf.edu)].
 
====Grading====
Divided into:<ref>{{Ref PBoD|1077}}</ref>
#Well-differentiated (keratinizing).
#Moderately differentiated (nonkeratinizing).
#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):
*<= 3 mm.
*Negative for [[vascular invasion]].
 
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.
 
<pre>
UTERINE CERVIX, BIOPSY:
- FRAGMENTS OF INVASIVE SQUAMOUS CELL CARCINOMA.
-- DEPTH OF INVASION AND LENTH OF TUMOUR CANNOT BE ASSESSED.
-- LYMPHOVASCULAR INVASION NOT APPARENT.
</pre>


==Adenocarcinoma of the uterine cervix==
==Adenocarcinoma of the uterine cervix==
Michael
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