| • This intermediate power view is of a squamous carcinoma.
• No normal cervix is identified.
• The cells are arranged in sheets.
• Many nuclei are rather pale with large dark nucleoli.
• The stroma contains fibrous tissue.
• There is nuclear pleomorphism. |
| Squamous Carcinoma of Cervix |
| Etiology |
•human papillomavirus (HPV) particularly types 16,18,31,33,35 |
| Pathogenesis |
•integration into host genome of HPV with inactivation of p53 •area of active research |
| Epidemiology |
•sexually transmitted disease
particularly affecting
young women •increased in cigarette smokers •age peak at 40-45 but dropping •women who have never had a pap smear or have not had one
in 5 years |
| Clinical |
•symptoms of vaginal bleeding (post-coital) and
discharge •most neoplasms are found at Stage I (confined to cervix) •spread is contiguous into paracervical tissues and/or
proximal vagina (Stage II) to the pelvic sidewall and/or
lower vagina (Stage III) or into rectal or bladder mucosa
(Stage IV) •death from hemorrhage, infection, or obstruction of ureters
or bowel •treatment with surgery or radiation (Stage I), radiation for
later stages (+/-) chemotherapy |
| General Gross Description |
•usually fungating, may be ulcerated or
infiltrative •cut surfaces gray white, hard, poorly circumscribed •necrosis and hemorrhage common |
| General Micro Description |
•usually non-keratinizing or keratinizing, rarely small cell •sheets or nests with individually keratinized cells or pearls •round to oval nuclei, coarsely granular chromatin •prominent nucleoli |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1052-1053
|