Difference between revisions of "Adenocarcinoma of the uterine cervix"
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'''Adenocarcinoma of the uterine cervix''' is a relative uncommon form of cervical [[cancer]]. Like the more common [[squamous cell carcinoma of the cervix]], it is associated strongly with the [[human papilloma virus]]. | |||
It is also known as '''endocervical adenocarcinoma''' and '''cervical adenocarcinoma'''. | |||
==General== | |||
*Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix. | |||
*Arises from the endocervical glands. | |||
==Microscopic== | |||
Features: | |||
*Stromal changes - "[[desmoplastic stroma]]/[[desmoplastic reaction]]". | |||
**Fibrosis/streaming cells. | |||
*Gland fusion. | |||
*Glands too deep -- very fuzzy criterion. | |||
Notes: | |||
*AIS changes - similar to [[colon|colonic]] dysplasia. | |||
*AIS may occur together with CIN. | |||
**Not infrequently they (AIS, CIN) occur together - both are due, indirectly, to HPV infection. | |||
*May be difficult to be certain of invasion. | |||
**A feature suggestive of invasion is ''cytoplasmic eosinophilia''. | |||
DDx: | |||
*[[Microglandular hyperplasia]] - [[NC ratio]] normal, no nuclear atypia. | |||
*[[Endocervical adenocarcinoma in situ]]. | |||
*[[Villoglandular adenocarcinoma]]. | |||
*[[Glassy cell carcinoma]]. | |||
*Metastatic adenocarcinoma. | |||
**[[Endometrioid endometrial carcinoma]]. | |||
**[[Serous endometrial carcinoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Cervical_adenocarcinoma_-_low_mag.jpg | Cervical adenocarcinoma - low mag. (WC) | |||
Image:Cervical_adenocarcinoma_-_intermed_mag.jpg | Cervical adenocarcinoma - intermed. mag. (WC) | |||
Image:Cervical_adenocarcinoma_-_high_mag.jpg | Cervical adenocarcinoma - high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
Features for diagnosis: | |||
*p16 +ve. | |||
*Ki-67 -- high. | |||
Uterus vs. cervix:<ref>LAE. 15 January 2009.</ref> | |||
*Cervix (typically): CEA +ve, p16 +ve. | |||
**ER -ve, PR -ve, vimentin -ve. | |||
*Uterus (typically): vimentin +ve, ER +ve, PR +ve. | |||
**CEA -ve, p16 -ve. | |||
==See also== | |||
*[[Uterine cervix]]. | |||
*[[Gynecologic cytopathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Uterine cervix]] |
Revision as of 03:38, 22 February 2014
Adenocarcinoma of the uterine cervix is a relative uncommon form of cervical cancer. Like the more common squamous cell carcinoma of the cervix, it is associated strongly with the human papilloma virus.
It is also known as endocervical adenocarcinoma and cervical adenocarcinoma.
General
- Adenocarcinoma of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix.
- Arises from the endocervical glands.
Microscopic
Features:
- Stromal changes - "desmoplastic stroma/desmoplastic reaction".
- Fibrosis/streaming cells.
- Gland fusion.
- Glands too deep -- very fuzzy criterion.
Notes:
- AIS changes - similar to colonic dysplasia.
- AIS may occur together with CIN.
- Not infrequently they (AIS, CIN) occur together - both are due, indirectly, to HPV infection.
- May be difficult to be certain of invasion.
- A feature suggestive of invasion is cytoplasmic eosinophilia.
DDx:
- Microglandular hyperplasia - NC ratio normal, no nuclear atypia.
- Endocervical adenocarcinoma in situ.
- Villoglandular adenocarcinoma.
- Glassy cell carcinoma.
- Metastatic adenocarcinoma.
Images
IHC
Features for diagnosis:
- p16 +ve.
- Ki-67 -- high.
Uterus vs. cervix:[1]
- Cervix (typically): CEA +ve, p16 +ve.
- ER -ve, PR -ve, vimentin -ve.
- Uterus (typically): vimentin +ve, ER +ve, PR +ve.
- CEA -ve, p16 -ve.
See also
References
- ↑ LAE. 15 January 2009.