Difference between revisions of "Uterine cervix"

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Uterine cervix (view source)

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→‎Squamous metaplasia of the uterine cervix: split out
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==Squamous metaplasia of the uterine cervix==
==Squamous metaplasia of the uterine cervix==
*Abbreviated ''SMC''.
*Abbreviated ''SMC''.
===General===
{{Main|Squamous metaplasia of the uterine cervix}}
*Benign process: columnar cells -> squamoid cells.
**Biologic response to irritation and/or inflammation.
 
===Gross===
*[[Acetowhite epithelium|Acetowhite lesion]].<ref name=pmid19256708>{{Cite journal  | last1 = Li | first1 = W. | last2 = Venkataraman | first2 = S. | last3 = Gustafsson | first3 = U. | last4 = Oyama | first4 = JC. | last5 = Ferris | first5 = DG. | last6 = Lieberman | first6 = RW. | title = Using acetowhite opacity index for detecting cervical intraepithelial neoplasia. | journal = J Biomed Opt | volume = 14 | issue = 1 | pages = 014020 | month =  | year =  | doi = 10.1117/1.3079810 | PMID = 19256708 }}</ref>
 
===Microscopic===
Features:
* Uniform cell spacing - no crowding - '''key feature'''.
* Nuclei are uniform size and round.
** [[Nucleoli]] present.
*Distinct cell borders
* +/-Intercellular bridges (due to edema) - common.
* Adjacent/closely associated with columnar epithelium.
** Columnar epithelium superficial in immature metaplasia.
 
Negatives:
* No mitoses (think cancer/CIN if you see 'em).
* Usually no hyperchromatism (think cancer/CIN if you see it).
 
Notes:
*NC ratio high - possible to confuse with CIN III.
*May have goblet cells - uncommon.<ref name=pmid21077478>{{Cite journal  | last1 = Sivridis | first1 = E. | last2 = Karpathiou | first2 = G. | last3 = Malamou-Mitsi | first3 = V. | last4 = Giatromanolaki | first4 = A. | title = Intestinal-type metaplasia in the original squamous epithelium of the cervix. | journal = Eur J Gynaecol Oncol | volume = 31 | issue = 3 | pages = 319-22 | month =  | year = 2010 | doi =  | PMID = 21077478 }}</ref>
 
DDx:
*[[CIN II]] - esp. for immature squamous metaplasia.
*[[CIN III]].
*[[Squamous cell carcinoma of the uterine cervix]].
 
Images:
*[http://www.sciencephoto.com/media/294722/view Squamous metaplasia - cervix (sciencephoto.com)].
*[http://commons.wikimedia.org/wiki/File:Bronchial_squamous_metaplasia.jpg Squamous metaplasia - bronchus (WC)].
*[http://nih.techriver.net/patientImages%5C6676.jpg Squamous metaplasia - cytology (techriver.net)].
*[http://www.eurocytology.eu/static/eurocytology/eng/cervical/mod1img4b.html Immature squamous metaplasia (eurocytology.eu)].<ref>URL: [http://www.eurocytology.eu/static/eurocytology/eng/cervical/LP1ContentAcontD.html http://www.eurocytology.eu/static/eurocytology/eng/cervical/LP1ContentAcontD.html]. Accessed on: 9 October 2013.</ref>
 
===IHC===
*p16 weak-to-moderate patchy +ve -- checkerboard-like; not full thickness.
**Strong diffuse full thickness positivity in HSIL and SCC.
*Ki-67 - low proliferative rate.
 
===Sign out===
====ECC====
<pre>
UTERINE ENDOCERVIX, CURETTAGE:
- SQUAMOUS METAPLASTIC EPITHELIUM.
- VERY SCANT STRIPPED ENDOCERVICAL EPITHELIUM.
</pre>
 
====Cervical biopsy====
<pre>
UTERINE CERVIX, BIOPSY:
- SQUAMOUS METAPLASTIC EPITHELIUM.
- SCANT BENIGN ENDOCERVICAL GLANDS.
</pre>
 
<pre>
UTERINE CERVIX, BIOPSY:
- SQUAMOUS METAPLASTIC EPITHELIUM.
- SCANT BENIGN ENDOCERVICAL GLANDS.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
 
====Micro====
The sections show stratified squamous epithelium. The cells are equally spaced and spaces are seen between the cells (edema). 
 
The nuclei are not significantly enlarged (<3x resting lymphocyte diameter). No nuclear halos are apparent.  The nuclear membranes are regular.  Mild inflammation is present. Nucleoli are present focally.
 
No endocervical cells are identified.


==Reactive squamous epithelium of the uterine cervix==
==Reactive squamous epithelium of the uterine cervix==
Michael
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