Morphology of carcinoma cervix

Morphology of carcinoma cervix

• Types of cervical carcinomas

  • Squamous cell carcinoma – most common – 80%

  • Adenocarcinoma – 15%

  • Adenosquamous  (0-5%)

  • Neuroendocrine carcinoma (0-5%)

  • Clear cell carcinoma (rare)

MORPHOLOGY

• Grossly

  •  Three distinctive patterns are

    • Fungating or exophytic

    • Ulcerating

    • Infiltrative cancer

  • The most common variant is the fungating tumor Which produces mass that projects above the surrounding mucosa

• Histologic examination

  • Squamous cell carcinoma – Tumor shows sheets of pleomorphic squamous cells. Depending upon the differentiation of tumor cells they are further divided into

    •    Well differentiated – Tumor cells are large with keratinizing cytoplasm. Keratin pearls are present 

    • Moderately differentiated – Tumor cells with Non keratinizing cytoplasm 

    • Poorly differentiated small cell sq. carcinoma (less than 5%)

    • Small cell undifferentiated carcinoma (neuroendocrine or oat cell carcinoma)    

  • Adenocarcinoma

    • Arises in the endocervical glands and are often preceeded by an intraepithelial glandular neoplasm termed as adenocarcinoma insitu (Associated with HPV type 18).

    • Tumor cells are arranged in glandular pattern

  • Adenosquamous 

    • Have mixed glandular & squamous patterns

    • thought to arise from the multipotent reserve cells in the basal layers of the endocervical epithelium.

  • Clear cell carcinoma 

    • Tumor cells are arranged in glandular pattern, sheets and show clear cytoplasm. these tumors are seen in Diethylstilbesterol exposed females

References

• Lora Hedrick Ellenson, Edyta C pirog. The Female genital tract. In:Robbins and Cotran Pathologic basis of disease.2015. 9 edition. volume II.pg 991-1042