Cellular Pathology of Glandular Lesions and Uncommon Neoplasms of the Cervix

This book provides a comprehensive account of the cellular pathology of glandular lesions and uncommon neoplasms of the cervix and places these in a contemporary clinical context. The book features comprehensive, detailed descriptions and a consistent approach to each tumor or tumor-like condition with clear color illustrations. Cytological/histological correlation is emphasised and diagnostic pitfalls are highlighted. __Cellular Pathology of Glandular Lesions and Uncommon Neoplasms of the Cervix__ is aimed at both trainee and consultant pathologists. Contents 6 Introduction 12 1: The Normal Cervix 14 Structure and Development 14 Cervical Epithelium 15 Squamous Epithelium 15 Columnar Mucin Secreting Epithelium 15 Squamocolumnar Junction 17 Metaplastic Squamous Epithelium and the Transformation Zone 18 Cytology of Normal Endocervical Epithelium 20 References 23 2: Benign Endocervical Glandular Lesions 25 Introduction 25 Metaplasias and Ectopias of Endocervical Glands 26 Tubal Metaplasia, Tuboendometrial Metaplasia (TEM) and Superficial Endometriosis 26 Deep Endometriosis 30 Atypical Oxyphilic Metaplasia 31 Intestinal Metaplasia 32 Simple Gastric (Pyloric) Metaplasia 32 Arias-Stella Reaction 33 Endocervicosis 33 Endosalpingiosis/Florid Cystic Endosalpingiosis 34 Ectopic Prostatic Tissue 35 Sebaceous Glands and Hair Follicle Structures 36 Endocervical Glandular Hyperplasias 37 Tunnel Clusters 37 Lobular Endocervical Glandular Hyperplasia (LEGH) 38 Diffuse Laminar Endocervical Glandular Hyperplasia (DLEGH) 42 Deep Glands and Nabothian Cysts 42 Microglandular Hyperplasia (MGH) 42 Mesonephric Remnants and Mesonephric Gland Hyperplasia 46 Adenoid Basal Hyperplasia 49 Reactive and Inflammatory Lesions 49 Endocervical Polyps 49 Inflammatory Atypia 51 Papillary Endocervicitis 52 Follicular Cervicitis 52 Radiation-Associated Change/Atypia 52 Changes Secondary to Mucin Extravasation 53 Cytomegalovirus Infection 53 Cautery Artefact 54 Multinucleate Endocervical Cells 54 Endocervical Glandular Changes Secondary to Recent Endometrial Curettage or Biopsy 55 Benign Glandular Neoplasms 57 Endocervical Adenomyoma 57 Villous Adenoma 59 Cervical Adenofibroma 59 Mullerian Papilloma 59 References 59 3: Premalignant Glandular Lesions of the Cervix 64 Introduction 64 Terminology of Premalignant Endocervical Glandular Lesions 65 Aetiology and Pathogenesis of Premalignant Endocervical Glandular Lesions 65 Clinical Features of Premalignant Endocervical Glandular Lesions 66 Evidence for Low Grade CGIN Being a Premalignant Lesion 66 Morphological Features of CGIN 66 Usual or Endocervical Type CGIN 66 Intestinal Type CGIN 71 Endometrioid Type CGIN 73 Tubal (Ciliated) Type CGIN 73 Immunohistochemistry of Premalignant Endocervical Glandular Lesions 73 Differential Diagnosis of CGIN 77 Management of CGIN 77 Stratified Mucin Producing Intraepithelial Lesion (SMILE) 78 Morphological and Immunohistochemical Features of SMILE 78 References 79 4: Malignant Glandular Lesions of the Cervix 82 Introduction 82 Early Invasive Adenocarcinoma 83 Morphological Features of Early Invasive Adenocarcinoma 83 Measurement of Early Invasive Adenocarcinoma 86 Management of Early Invasive Adenocarcinoma 86 Cervical Adenocarcinoma 87 Gross Features of Primary Cervical Adenocarcinomas 87 Usual Type Cervical Adenocarcinoma (Mucinous Adenocarcinoma of Endocervical Type) 87 Management and Prognosis of Cervical Adenocarcinomas 92 Intestinal Type Mucinous Adenocarcinoma 94 Signet-Ring Cell Mucinous Adenocarcinoma 96 Mucinous Variant of Minimal Deviation Adenocarcinoma (Adenoma Malignum) 96 Gastric Type Cervical Adenocarcinoma 100 Villoglandular Adenocarcinoma 102 Endometrioid Adenocarcinoma 103 Clear Cell Adenocarcinoma (Clear Cell Carcinoma) 104 Serous Adenocarcinoma 105 Mesonephric Adenocarcinoma 106 Adenosquamous Carcinoma 109 Mucoepidermoid Carcinoma 110 Glassy Cell Carcinoma 110 Adenoid Cystic Carcinoma 110 Adenoid Basal Carcinoma 111 Mixed Adenocarcinomas 113 Metastatic Adenocarcinoma 113 Distinction Between Endometrial and Cervical Adenocarcinoma 116 References 117 5: Other Neoplasms of the Cervix 123 Introduction 123 Neuroendocrine Neoplasms 123 Definition and General Comments 123 Morphological Features of SCNEC 124 Morphological Features of LCNEC 125 Immunohistochemistry 126 Prognosis 127 Transitional Neoplasms 127 Mesenchymal Neoplasms 129 Smooth Muscle Neoplasms 129 Embryonal Rhabdomyosarcoma 129 Myofibroblastoma of the Lower Female Genital Tract 132 Other Mesenchymal Neoplasms 134 Mixed Epithelial and Mesenchymal Neoplasms 135 Carcinosarcoma 135 Adenofibroma and Adenosarcoma 135 Haematopoietic Lesions 139 Lymphomas and Leukaemias 139 Lymphoma-Like Lesion 140 Melanocytic Neoplasms 141 Miscellaneous Neoplasms 141 References 142 6: Cytology of Glandular Lesions 144 Introduction 144 Cervical Glandular Intraepithelial Neoplasia (CGIN)/Adenocarcinoma In Situ (AIS) 144 Mimics of CGIN 151 Endocervical Crypt Involvement by High Grade CIN (CIN 2/3) (HSIL) 151 Inflammatory Change in Endocervical Cells and Benign Endocervical Polyps 153 Cervical Endometriosis and Lower Uterine Segment Sampling 153 Tubal and Tuboendometrioid Metaplasia 155 Microglandular Hyperplasia 157 Arias-Stella Change 158 Radiation Associated Changes 158 Stratified Mucin Producing Intraepithelial Lesion (SMILE) 158 Invasive Adenocarcinoma 159 Endocervical Type Cervical Adenocarcinoma 159 Endometrioid Adenocarcinoma of the Cervix 161 Minimal Deviation Adenocarcinoma 162 Villoglandular Cervical Adenocarcinoma (VGA) 162 Clear Cell Carcinoma 164 Serous Carcinoma 165 Adenosquamous Carcinoma 165 Glassy Cell Carcinoma 165 Adenoid Cystic Carcinoma and Adenoid Basal Carcinoma 166 References 167 7: Cytology of Other Neoplasms of the Cervix 170 Introduction 170 Neuroendocrine Neoplasms 170 Transitional Neoplasms 172 Mesenchymal Tumours 172 Smooth Muscle Neoplasms 172 Embryonal Rhabdomyosarcoma 172 Myofibroblastoma 172 Other Mesenchymal Neoplasms 172 Mixed Epithelial and Mesenchymal Neoplasms 173 Carcinosarcoma (Malignant Mixed Mullerian Tumour) 173 Adenofibroma and Adenosarcoma 173 Adenomyoma and Atypical Adenomyoma 173 Lymphoma, Leukaemia and Myeloma 174 Melanocytic Neoplasms 175 Blue Naevus 175 Malignant Melanoma 175 Metastatic Tumours 176 References 178 8: Colposcopy and Management of Glandular Neoplasia 181 Introduction 181 Cervical Glandular Intra-epithelial Neoplasia 181 Incidence 181 Aetiology 182 The Role of Colposcopy in the Diagnosis of Cervical Glandular Intra-epithelial Neoplasia 182 Management of Women with? Endo-cervical Glandular Neoplasia 183 Diagnosis 183 Endo-cervical Curettage 183 Treatment 183 Management of Women with Borderline Changes in Endo-­cervical Cells 184 The Role of Repeat Excision 185 Management of Squamous Mucin Intra-epithelial Lesion (SMILE) 185 Follow Up of Women Treated for CGIN 185 Invasive Adenocarcinoma of the Cervix 185 Early Stage Adenocarcinoma of the Cervix 186 Local Excision 186 Stage 1B Adenocarcinoma 186 Advanced Adenocarcinoma of the Cervix 187 Rare Variants of Adenocarcinoma of the Cervix 187 Conclusions 187 References 188 Index 190 "This book provides a comprehensive account of the cellular pathology of glandular lesions and uncommon neoplasms of the cervix and places these in a contemporary clinical context The book features comprehensive, detailed descriptions and a consistent approach to each tumor or tumor-like condition with clear color illustrations Cytological/histological correlation is emphasised and diagnostic pitfalls are highlighted Cellular Pathology of Glandular Lesions and Uncommon Neoplasms of the Cervix is aimed at both trainee and consultant pathologists - Font no determinada Front Matter....Pages i-xii The Normal Cervix....Pages 1-11 Benign Endocervical Glandular Lesions....Pages 13-51 Premalignant Glandular Lesions of the Cervix....Pages 53-70 Malignant Glandular Lesions of the Cervix....Pages 71-111 Other Neoplasms of the Cervix....Pages 113-133 Cytology of Glandular Lesions....Pages 135-160 Cytology of Other Neoplasms of the Cervix....Pages 161-171 Colposcopy and Management of Glandular Neoplasia....Pages 173-181 Back Matter....Pages 183-187 W. Glenn Mccluggage, John Tidy, John H.f. Smith. Includes Bibliographical References And Index. Mode Of Access: World Wide Web.