•  The image is composed of neoplastic cells with round to oval nuclei.

•  The nuclei contain prominent nucleoli and show irregular nuclear outlines.

•  Occasionally intercellular bridges can be identified (black arrows point to a region in which they can be found.)

•  The red arrow points to a mitotic figure.

•  Keratinization cannot be identified.

•human papillomavirus (HPV) particularly types 16,18,31,33,35

•integration into host genome of HPV with inactivation of p53

•area of active research

•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

•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

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•usually fungating, may be ulcerated or infiltrative

•cut surfaces gray white, hard, poorly circumscribed

•necrosis and hemorrhage common

•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

• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1052-1053

• Current literature from PubMed at National Library of Medicine