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Flashcards in Cervix Deck (29)
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1

lined by hormonally responsive stratified
squamous epithelium (noncornified); post-puberty, mature
cells store glycogen, which supports growth of normal flora

•Ectocervix

2

lined by simple columnar epithelium;
endocervical glands are crypt-like spaces lined by the same
epithelium

•Endocervix

3

Etiology of Acute cervicitis

• Endocervix (not erosion)
• Gonococcal, Chlamydia, Candida,
Trichomonas, Herpes
• Post partum, Post D & C
• Purulent vaginal discharge

4

Etiology of chronic cervicitis

• Non-specific, incidental
• Lymphocytes and plasma cells normally present in
wall
• Granularity, thickening
• Retention (Nabothian) cysts

5

In cervix
• Non-specific response to irritation
• No malignant potential

Squamous metaplasia

6

Signs of Endocervical polyp

Pre-menopausal
• Vaginal spotting
• Dilated endocervical glands, vascularity,
edema, inflammation
• No malignant potential

7

Condyloma accuminatum associated with

STD, HPV 6, 11

8

Lab of Condyloma accuminatum

Papillomatous, koilocytes

9

Seen in 20s-30s can enlarge during pregnancy

Condyloma accuminatum

10

What are the HPV strains associated with CIN

HPV 16, 18, 31, 33, 35, 45 (high risk)
• HPV 6, 11, 40, 54 (low risk)

11

Risk factors for
• Sexual activity at a young age
• Multiple sex partners
• Parity (>7)
• High viral load
• Immunosuppression
• Certain HLA subtypes
• Chlamydial infection
• Smoking

CIN

12

Features of abnormal maturation in CIN

That orderly sequence of maturation from bottom to top of
the epithelium is lost beginning at the basal layer and
progressing until the entire thickness of the epithelium is
involved. Nuclei remain large; cells remain cuboidal;
glycogen is not stored; mitoses above basement membrane.

13

Schiller test

Schiller test – paint cervix with iodine - look for
unstained pale patches

14

pap smear guidlines

Test every 3 years beginning age 21

15

Signs of CIN I

Koilocytic atypia - enlarged hyperchromatic irregular nuclei

16

Signs of CIN II-III

Increased N:C ratio
Pleomorphic, hyperchromatic nuclei

17

Prognosis of CIN I (LSIL)

60% Regress
30% persist
10% to HSIL

18

Prognosis of CIN II-III (HSIL)

30% regress
60% persist
10% ca

19

Most common cause of death for carcinoma of cervix

pyelonephritis, uremia, ureteral obstruction

20

Distant mets of cervix carcinoma

liver, lung, bone marrow

21

HPV association for cervix carcinoma

HPV 16, 18, 31, 33

22

Age cervix carcinoma

30-50 yrs

23

Clinic-
Irregular vaginal bleeding
• Postcoital bleeding
• Vaginal discharge
• Pyometra – due to obstruction
• Colposcopic biopsy
• Surgery and radiation

cervix carcinoma

24

Exophytic cervix carcinoma

Necrotic fungating mass

25

Stage IA
Micro-invasive carcinoma

• Depth =/< 5mm from basement membrane of the
epithelium and Width no more than 7mm
• No lymphatics, blood vessels invasion
• Surgical excision curative- cone biopsy or simple
hysterectomy
• Stage Ia tumours can only be diagnosed in cone biopsies or
hysterectomy specimens

26

Histo
Stage IA micro-invasive carcinoma

• Squamous cell carcinoma - squamous cells with
keratin pearls.

27

Age of adenocarcinoma

4th decade

28

Adenocarcinoma HPV association

16/18

29

20% history of CIN
• Asymptomatic
• Visible lesion – absent/rare
• Multifocal 15%
• Associated lesion – CIN – 50-70%

Adenocarcinoma