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Research Article| Volume 15, ISSUE 3, P493-516, September 1995

Surgical Pathology of the Uterine Cervix: Diagnostic Problems and Controversies

  • Joshua Z. Sickel
    Correspondence
    Address reprint requests to Joshua Z. Sickel, MD Department of Pathology El Camino Hospital 2500 Grant Road Mountain View, CA 94039-7025
    Affiliations
    From the Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York
    Search for articles by this author
DOI:https://doi.org/10.1016/S0272-2712(18)30316-0
Surgical Pathology of the Uterine Cervix: Diagnostic Problems and Controversies
Previous ArticleUpdate on the Surgical Pathology of the Vulva
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      This paper is only available as a PDF. To read, Please Download here.
      Biopsy samples from the uterine cervix account for a significant percentage of the routine caseload encountered in surgical pathology. This article highlights some controversial topics, including microinvasive squamous cell carcinoma and early (microinvasive) adenocarcinoma. A variety of distinctive malignant neoplasms and certain benign “tumor-like” conditions that may be confused with malignancy are reviewed. Finally, the recently introduced large loop excision of the transformation zone (LLETZ) biopsy technique is briefly discussed.
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      References

        • Andersen E.S.
        • Arffmann E.
        Adenocarcinoma in situ of the uterine cervix—a histologic and immunohistologic study.
        Gynecol Oncol. 1989; 35: 38-43
        • Angel C.A.
        • DuBeshter B.
        • Lin J.Y.
        Clinical presentation and management of stage I cervical adenocarcinoma: A 25 year experience.
        Gynecol Oncol. 1992; 44: 71-78
        • Averette H.E.
        • Nelson J.H.
        • Ng ABP
        • et al.
        Diagnosis and management of microinvasive (stage IA) carcinoma of the uterine cervix.
        Cancer. 1976; 38: 414-425
        • Ayroud Y.
        • Gelfand M.M.
        • Ferenczy A.
        Florid mesonephric hyperplasia of the cervix: A report of a case with review of the literature.
        Int J Gynecol Pathol. 1985; 4: 245-254
        • Baggish M.S.
        • Woodruff J.D.
        Adenoid basal carcinoma of the cervix.
        Obstet Gynecol. 1966; 28: 213
        • Berek J.S.
        • Hacker N.F.
        • Fu Y.S.
        • et al.
        Adenocarcinoma of the uterine cervix: Histologic variables associated with lymph node metastasis and survival.
        Obstet Gynecol. 1985; 65: 46-52
        • Bloss J.D.
        The use of electrosurgical techniques in the management of premalignant diseases of the vulva, vagina, and cervix: An excisional rather than an ablative approach.
        Am J Obstet Gynecol. 1993; 169: 1081-1085
        • Bostrom S.G.
        • Hart W.R.
        Carcinomas of the cervix with intense stromal eosinophilia.
        Cancer. 1981; 47: 2887-2893
        • Boyce J.
        • Fruchter R.G.
        • Nicastri A.D.
        • et al.
        Prognostic factors in Stage I carcinoma of the cervix.
        Gynecol Oncol. 1981; 12: 154
        • Brand E.
        • Berek J.S.
        • Hacker N.F.
        Controversies in the management of cervical adenocarcinoma.
        Obstet Gynecol. 1988; 71: 261-269
        • Burghardt E.
        Microinvasive carcinoma in gynecological pathology.
        Clin Obstet Gynecol. 1984; 11: 239-257
        • Burghardt E.
        • Girardi F.
        • Lahousen M.
        • et al.
        Microinvasive carcinoma of the uterine cervix (International Federation of Gynecology and Obstetrics Stage IA).
        Cancer. 1991; 67: 1037-1045
        • Buscema J.
        • Woodruff J.D.
        Significance of neoplastic atypicalities in endocervical epithelium.
        Gynecol Oncol. 1984; 17: 356-362
        • Costa M.J.
        • Kenny M.B.
        • Hewan-Lowe K.
        • et al.
        Glassy cell features in adenosquamous carcinoma of the uterine cervix: Histologic, ultrastructural, immunohistochemical, and clinical findings.
        Am J Clin Pathol. 1991; 96: 520-528
        • Creasman W.T.
        • Fetter B.F.
        • Clarke-Pearson
        • et al.
        Management of stage IA carcinoma of the cervix.
        Am J Obstet Gynecol. 1985; 153: 164-172
        • Delgado G.
        • Bundy B.
        • Zaino R.
        • et al.
        A prospective surgical pathological study of stage I squamous carcinoma of the cervix: A Gynecologic Oncology Group study.
        Gynecol Oncol. 1989; 35: 314-320
        • Ferry J.A.
        • Scully R.E.
        “Adenoid cystic” carcinoma and adenoid basal carcinoma of the uterine cervix. A study of 28 cases.
        Am J Surg Pathol. 1988; 12: 134-144
        • Ferry J.A.
        • Scully R.E.
        Mesonephric remnants, hyperplasia and neoplasia in the uterine cervix: A study of 49 cases.
        Am J Surg Pathol. 1990; 14: 1100-1111
        • Fluhmann C.F.
        Focal hyperplasia (tunnel clusters) of the cervix uteri.
        Obstet Gynecol. 1961; 17: 206-214
        • Fowler W.C.
        • Miles P.A.
        • Surwit E.A.
        • et al.
        Adenoid cystic carcinoma of the cervix. Report of 9 cases and a reappraisal.
        Obstet Gynecol. 1978; 52: 337
        • Gilks C.B.
        • Young R.H.
        • Aguirre P.
        • et al.
        Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix: a clinicopathological and immunohistochemical analysis of 26 cases.
        Am J Surg Pathol. 1989; 13: 717-729
        • Glucksmann A.
        • Cherry C.P.
        Incidence, histology, and response to radiation of mixed carcinomas (adenoacanthomas) of the uterine cervix.
        Cancer. 1956; 9: 971-979
        • Halpin T.F.
        • Hunter R.E.
        • Cohen M.B.
        Lymphoepithelioma of the uterine cervix.
        Gynecol Oncol. 1989; 34: 101-105
        • Hamazaki M.
        • Fujita H.
        • Ara T.
        • et al.
        Medullary carcinoma with marked lymphoid infiltration of the uterine cervix.
        Jpn J Cancer Clin. 1968; 14: 787
        • Hasumi K.
        • Sugano H.
        • Sakamoto G.
        • et al.
        Circumscribed carcinoma of the uterine cervix with marked lymphocytic infiltration.
        Cancer. 1977; 39: 2503-2507
        • Hasumi K.
        • Sakamoto A.
        • Sugano H.
        Microinvasive carcinoma of the uterine cervix.
        Cancer. 1980; 45: 928-931
        • Hoskins W.J.
        • Averette H.E.
        • Ng ABP
        • et al.
        Adenoid cystic carcinoma of the cervix uteri: Report of six cases and review of the literature.
        Gynecol Oncol. 1979; 7: 371
        • Howell R.
        • Hammond R.
        • Pryse-Davies J.
        The histologic reliability of laser cone biopsy of the cervix.
        Obstet Gynecol. 1991; 77: 905-911
        • Huettner P.C.
        • Gersell D.J.
        Placental site nodule: A clinicopathologic study of 38 cases.
        Int J Gynecol Pathol. 1994; 13: 191-198
        • Huettner P.C.
        • Gersell D.J.
        Arias-Stella reaction in nonpregnant woman: A clinicopathologic study of nine cases.
        Int J Gynecol Pathol. 1994; 13: 241-247
        • Jaworski R.C.
        • Pacey N.F.
        • Greenberg M.L.
        • et al.
        The histologic diagnosis of adenocarcinoma in-situ and related lesions of the cervix uteri: Adenocarcinoma in-situ.
        Cancer. 1988; 61: 1171-1181
        • Kapp D.S.
        • LiVolsi V.A.
        Intense eosinophilic stromal infiltration in carcinoma of the uterine cervix: A clinicopathologic study of 14 cases.
        Gynecol Oncol. 1983; 16: 19-30
        • Kaspar H.G.
        • Dinh T.V.
        • Doherty M.G.
        • et al.
        Clinical implications of tumor volume measurement in stage I adenocarcinoma of the cervix.
        Obstet Gynecol. 1993; 81: 296-300
        • Keijser K.G.
        • Kenemans P.
        • Petronella H.H.
        • et al.
        Diathermy loop excision in the management of cervical intraepithelial neoplasia: Diagnosis and treatment in one procedure.
        Am J Obstet Gynecol. 1992; 166: 1281-1287
        • Kolstad P.
        Follow-up study of 232 patients with stage Ial and 411 with stage Ia2 squamous cell carcinoma of the cervix (microinvasive carcinoma).
        Gynecol Oncol. 1989; 33: 265-272
        • Krebs H.B.
        • Pastore L.
        • Helmkamp B.F.
        Loop electrosurgical excision procedures for cervical dysplasia: Experience in a community hospital.
        Am J Obstet Gynecol. 1993; 169: 289-295
        • Krummins I.
        • Young Q.
        • Pacey N.F.
        • et al.
        The cytologic diagnosis of adenocarcinoma insitu of the cervix uteri.
        Acta Cytol. 1977; 21: 320-329
        • Littman P.
        • Clement P.B.
        • Henriksen B.
        • et al.
        Glassy cell carcinoma of the cervix.
        Cancer. 1976; 37: 2238-2246
        • Maier R.C.
        • Norris H.J.
        Glassy cell carcinoma of the cervix.
        Obstet Gynecol. 1982; 60: 219-224
        • Maiman M.A.
        • Fuchter R.G.
        • Dimnio T.M.
        • et al.
        Superficially invasive squamous cell carcinoma of the cervix.
        Obstet Gynecol. 1988; 72: 399-403
        • Mazur M.Y.
        • Battifora H.A.
        Adenoid cystic carcinoma of the uterine cervix: Ultrastructure, immunofluorescence, and criteria for diagnosis.
        Am J Clin Pathol. 1982; 77: 494
        • Michael H.
        • Grawe L.
        • Kraus F.T.
        Minimal deviation endocervical adenocarcinoma: Clinical and histologic features, immunohistochemical for carcinoembryonic antigen, and differentiation from confusing benign lesions.
        Int J Gynecol Pathol. 1984; 3: 261-276
        • Miles P.A.
        • Norris H.J.
        Adenoid cystic carcinoma of the cervix.
        Obstet Gynecol. 1971; 38: 103
        • Mills S.E.
        • Austin M.B.
        • Randall M.E.
        Lymphoepithelioma-like carcinoma of the uterine cervix: A distinctive undifferentiated carcinoma with inflammatory stroma.
        Am J Surg Pathol. 1985; 9: 883-889
        • Montz F.J.
        • Holschneider C.H.
        • Thompson LDR
        Large-loop excision of the transformation zone: Effect on the pathological interpretation of resection margins.
        Obstet Gynecol. 1993; 81: 976-982
        • Musa A.G.
        • Hughes R.R.
        • Coleman S.A.
        Adenoid cystic carcinoma of the cervix: A report of 17 cases.
        Gynecol Oncol. 1985; 22: 167-173
        • Nordqvist SRB
        • Fidler W.J.
        • Woodruff J.M.
        • et al.
        Clear cell adenocarcinoma of the cervix and vagina.
        Cancer. 1976; 37: 858-871
        • Oyesanya O.A.
        • Amerasinghe C.N.
        • Manning EAD
        Outpatient excisional management of cervical intraepithelial neoplasia.
        Am J Obstet Gynecol. 1993; 168: 485-488
        • Pak H.Y.
        • Yokota S.B.
        • Paladugu R.R.
        • et al.
        Glassy cell carcinoma of the uterine cervix. Cytologic and clinicopathologic analysis.
        Cancer. 1983; 52: 307-312
        • Qizilbash A.H.
        In-situ and microinvasive adenocarcinoma of the uterine cervix: A clinical, cytologic and histologic study of 14 cases.
        Am J Clin Pathol. 1975; 64: 155-170
        • Rhatigan R.M.
        Endocervical gland atypia secondary to Arias-Stella change.
        Arch Pathol Lab Med. 1992; 116: 943-946
        • Robert M.E.
        • Fu Y.S.
        Squamous cell carcinoma of the uterine cervix—a review with emphasis on prognostic factors and unusual variants.
        Semin Diagn Pathol. 1990; 7: 173-189
        • Roche W.D.
        • Norris H.J.
        Microinvasive carcinoma of the cervix. The significance of lymphatic invasion and confluent patterns of stromal growth.
        Cancer. 1975; 36: 180-186
        • Rollason T.P.
        • Cullimore J.
        • Bradgate M.G.
        A suggested columnar cell morphological equivalent of squamous carcinoma in-situ with early stromal invasion.
        Int J Gynecol Oncol. 1989; 8: 230-236
        • Roth L.M.
        • Hornback N.B.
        Clear cell adenocarcinoma of the cervix in young women.
        Cancer. 1974; 34: 1761-1768
        • Saidi M.H.
        • Akright B.D.
        • Setzier F.D.
        • et al.
        Diagnostic and therapeutic conization using loop radiothermal cautery.
        J Reprod Med. 1993; 38: 775-779
        • Schneider V.
        Arias-Stella reaction of the endocervix (frequency and location).
        Acta Cytol. 1981; 25: 224-228
        • Sedlis A.
        • Sol S.
        • Tsukuda Y.
        • et al.
        Microinvasive carcinoma of the uterine cervix: A clinicopathologic study.
        Am J Obstet Gynecol. 1979; 133: 64-74
        • Segal G.H.
        • Hart WRP
        Cystic endocervical tunnel clusters: A clinicopathologic study of 29 cases of so-called adenomatous hyperplasia.
        Am J Surg Pathol. 1990; 14: 895-903
        • Seltzer V.
        • Sail S.
        • Castadot M.J.
        • et al.
        Glassy cell cervical carcinoma.
        Gynecol Oncol. 1979; 8: 141-149
        • Sevin B.U.
        • Nadji M.
        • Averette H.E.
        • et al.
        Microinvasive carcinoma of the cervix.
        Cancer. 1992; 70: 2121-2128
        • Simon N.L.
        • Gore H.
        • Shingleton H.M.
        • et al.
        Study of superficially invasive carcinoma of the cervix.
        Obstet Gynecol. 1986; 68: 19-24
        • Tamimi H.K.
        • Ek M.
        • Hesla J.
        • et al.
        Glassy cell carcinoma of the cervix redefined.
        Obstet Gynecol. 1988; 71: 837-841
        • Teshima S.
        • Shimosato Y.
        • Kishi K.
        • et al.
        Early stage adenocarcinoma of the uterine cervix: Histopathologic analysis with consideration of histogenesis.
        Cancer. 1985; 56: 167-172
        • Tsukamoto N.
        • Kaku T.
        • Matsukuma K.
        • et al.
        The problem of stage Ia (FIGO, 1985) carcinoma of the uterine cervix.
        Gynecol Oncol. 1989; 34: 1-6
        • Ulbright T.M.
        • Gersell D.J.
        Glassy cell carcinoma of the uterine cervix. A light and electron microscopic study of five cases.
        Cancer. 1983; 51: 2255-2263

      67. Van Dinh T, Woodruff D: Adenoid cystic and adenoid basal carcinomas of the cervix. 65:705, 1985

        • Van Nagell J.R.
        • Greenwell N.
        • Powell D.F.
        • et al.
        Microinvasive carcinoma of the cervix.
        Am J Obstet Gynecol. 1983; 145: 981-991
        • Vesterinen E.
        • Forss M.
        • Nieminen U.
        Increase in cervical adenocarcinoma: A report of 520 cases of cervical carcinoma including 112 tumors with glandular elements.
        Gynecol Oncol. 1989; 33: 49-53
        • Weiss L.M.
        • Gaffey M.J.
        • Shibata D.
        Lymphoepithelioma-like carcinoma and its relationship to Epstein-Barr virus.
        Am J Clin Pathol. 1991; 96: 156-158
        • Wright T.C.
        • Gagnon R.M.
        • Ferenczy A.
        Treatment of cervical intraepithelial neoplasia using the loop electrosurgical excision procedure.
        Obstet Gynecol. 1992; 79: 173-178
        • Young R.H.
        • Kurman R.J.
        • Scully R.E.
        Proliferations and tumors of intermediate tropho-blast of the placental site.
        Semin Diagn Pathol. 1988; 5: 223-237
        • Young R.H.
        • Kurman R.J.
        • Scully R.E.
        Placental site nodules and plaques. A clinicopathologic analysis of 20 cases.
        Am J Surg Pathol. 1990; 14: 1001-1009
        • Zaino R.J.
        • Nahhas W.A.
        • Mortel R.
        Glassy cell carcinoma of the uterine cervix. An ultrastructural study and review.
        Arch Pathol Lab Med. 1982; 106: 250-254

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      DOI: https://doi.org/10.1016/S0272-2712(18)30316-0

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      © 1995 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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