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Cervix (Inv. Squa. Cell. Carcinoma Risk factors (Clinical: (Pronosis…
Cervix
Inv. Squa. Cell. Carcinoma Risk factors
male on male
young age
Multiple Sex part
high parity
HPV persistent infection
HLA subtypes
Oral Contra
Nicotine
Clinical:
Uncommon before age 30
1/2 pt <50 yrs old
Cervical biopsy for diagnosis
Micro:
Inc. mitotic figures; atypical mitoses
*Keratinizing and non-keratinizing, depends on keratin pearls
nuclei uniform to pleomorphic
Pronosis
small cell neuroendocrine tumors=very poor
95% stage Ia
80-90% stage Ib
<50% stage III
75% stage II
Macro:
Exophytic infiltrative,
Ulcerative
ectocervix or endocervical canal
Cervical Squamous Intraepithelial Lesions (SIL)
preinvasive squamous lesions
link*HPV infection: 90% of HSIL lesions [HPV16]
dysplasia (mild-severe)
starts at transformation zone repleaces adjacent squamous & glandular epithelium
HX:
50%LSIL regress
10% high-grade lesions
1% invasive cancer
Micro
proliferation at basal llayers
loss polarity & cellular disorganization
Maturity related to severity of lesion
CLIN IMPT: distinction betw. LSIL & HSIL
Macro:
3-5% acetic acid seen
*twice often on Anterior lip of cervix than P.
Endocervical Polyp
S/Sx profuse leukorrhea
Polypoid lesion, loose myxomatous, dilated endocervical glands
Common new growth of uterine cervix
LE: Endocervical glandular epithelium or metaplastic epithelium
Cervix C. prec. lesions
Moderate dysplasia
CIN 2
High-grade squamous intraepithelial lesion (HSIL)
Severe dysplasia
CIN3
HSIL
Mild dysplasia
CIN1
low -grade squamous intraepithelial lesion(LSIL)
Squamous Intraepthelial Lesions (SIL)
Micro LSIL
(acanthosis) koilocytic atypica mid & upper epithelium
*Koilocytic atypia-nuclear atypica,wrinkle nuclear membrane, binucleate forms
Condyloma & CIN1
Koilocytic atypia
Nuclear atypia w/nuclear size, binucleate forms
CIN2 & CIN3 HSIL
koilocytic atypia maturation=CIN2
lesion w/o discernible maturation=CIN3