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11 Cards in this Set
- Front
- Back
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what are the essentials of cervix histology?
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ectocervix = portio with nonkeratinizing squamous epithelum continous with vaginal vault
squamo-columnar junction then endocervix with mucus-secreting columnar epithelium, also columnar epithelium in cervical glands in underlying stroma |
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what are the histology subtypes of cervical carcinoma?
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80% squamous cell carcinoma
15% adenocarcinoma 5% neuroendocrine and adenosquamous carcinoma |
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at what age is the peak incidence of cervical carcinoma?
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45 years
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what is the microscopic appearance of neuroendocrine cervical carcinoma?
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simliar to SCLC but positive for high-risk type HPVs
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how do cervical carcinomas spread?
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spread per continuitatem to paracervical tissues, vagina (stage II/III), ureters (stage III) later bladder, rectum (stage IV)
lymphogenous metastasis in diverse directions is typical! parametria, fossa obturatoria along arteria iliaca interna/externa, communis and paraaortal hematogenous metastases in liver, lung, bone marrow in <5% |
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what is the staging system for cervical carcinoma?
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stage 0
CIN III, HSIL stage I confined to cervix stage II beyond cervix, but not pelvic wall lower third of vagina stage III to pelvic wall to lower third of vagina stage IV beyond true pelvis or involves bladder or rectum metastatic dissemination |
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what is the prognosis in stages I/II vs III/IV of cervical carcinoma?
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5-year survival
>70% in stages I, II <50% in stages III, IV |
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what do patients with stage IV cervical cancer die of?
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complication of local extension, eg into bladder and ureter with obstruction, pyelonephritis, uremia
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what is the false negative rate of the Pap smear?
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10-20%, most due to sampling errors
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what is an adjunct to cytology (Pap smear) and in which age group?
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HPV DNA testing in women >30 years, because of high prevalence in those <30 years and thus low specificity
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what subtype are nonsquamous cervical carcinomas associated with?
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HPV-18, but HPV-16 otherwise most commonly associated
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