The histology and cytology of changes in the epithelium of the cervix uteri

ABNORMALITIES OF THE CERVICAL EPITHELIUM ARE SET OUT IN TWO MAIN GROUPS: bland lesions which are regarded as unrelated to malignancy, and malign lesions which are considered as potential precursors of invasive carcinoma. The histological features of each condition and the cytological pattern of the corresponding cervical smear are described and correlated.Cone biopsy is advocated as the only satisfactory form of cervical biopsy for both the diagnosis and evaluation of lesions such as dysplasia and carcinoma in situ. It is emphasized that further study is necessary to determine their natural history and prognosis in relation to invasive carcinoma.     

Adenocarcinoma of the cervix uteri

105 cases of uterine cervix adenocarcinoma (11 histological types) have been studied clinicomorphologically and immunohistochemically. Molecular-biological examination (in situ hybridization) for human papilloma viruses (HPV) detected HPV of 16/18 types not only in the coilocytes of the uterine cervix surface epithelium but in adenocarcinoma cells as well. Uterine cervix adenocarcinoma metastasize differently from uterine cervix squamous cell carcinoma.     

Bizarre leiomyoblastoma of the cervix uteri. Immunohistochemical and ultrastructural study

A case of bizarre leiomyoblastoma (BL) of the cervix uteri which developed in a 44-year-old premenopausal woman was reported. The tumor was found as a cervical polyp by routine pelvic examination. Histologically, it was composed of epithelioid and bizarre, often multinucleated, giant tumor cells without elevated mitotic counts and necrosis. Electronmicroscopically, abundant myofilaments in epithelioid tumor cells were observed. Immunoreactive desmin, CPK-MM (creatinine kinase mm-isozyme), and myosin could be demonstrated in most of the epithelioid tumor cells. These immunohistochemical findings seemed to reflect on the differentiation of the tumor cells to smooth muscle and provide a reliable evidence for the smooth muscle origin. The histogenesis and relationship between the histopathological findings and clinical behaviour of uterine BL were also discussed.     

Adenoid basal carcinoma of the cervix uteri

This paper describes a case of adenoid basal carcinoma of the uterine cervix, occurring in a woman aged 78 years. In view of the rarity and the limited knowledge of this group of neoplasms, details of the clinical history, the histological appearances, and the histochemical reactions are presented. An attempt is made to define the histogenesis of the tumour and some points on nonmenclature are discussed. It is suggested that the tumour arises from multipotential cervical basal cells and that the adenoid structures rather than being true glands are formed by degeneration of the connective tissue stroma. On the basis of a review of reported cases it seems possible that this tumour will be shown to be one of low-grade malignancy.     

Infections of the cervix uteri with human papillomavirus and Chlamydia trachomatis.

Apart from infection with human papillomavirus (HPV), other microorganisms may be involved in the development of cervical neoplasia. To study concomitant infections with HPV and Chlamydia trachomatis, cervical specimens from 4 groups of women were examined for the presence of these microorganisms by the polymerase chain reaction. The first group consisted of 143 consecutive samples from women with no cytological abnormalities who participated in a triennial screening program to prevent cervical cancer. In this group 2 samples were found positive for HPV and 2 additional samples were found positive for C. trachomatis. In the second group of 46 cytologically abnormal smears, HPV DNA was detected in 71.7% of the samples and C. tra chomatis in 4.3%. In a third group of 94 histological abnormal biopsies, the HPV prevalence ranged from 15% in mild dysplastic lesions up to 92% in invasive cervical carcinomas. Only 2 biopsies of this group (2.1%) were found positive for C. trachomatis. Finally, a group of cervical scrapes was obtained from women attending a clinic for sexually transmitted diseases. In 52 samples positive for C. trachomatis and 60 samples negative for C. trachomatis, no significant (P = 0.57) difference in the frequency of HPV infections was found (11.5% and 8.3%, respectively). The data show that in these study groups HPV and C. trachomatis are independently occurring agents.     

Morphology and histogenesis of dysplasias of the cervix uteri

Basic literature data on the morphology of the uterine cervix dysplasias and their relation to carcinoma in situ are summarized. The features of squamous cell and cambial (metaplastic) dysplasias, their ultrastructure and genesis are presented on the basis of authors' material. The notion "cervical intraepithelial neoplasia" is discussed. The opinion is expressed as to the incorrectness of the classification of dysplasia and carcinoma in situ in one category as the dysplasia is morphological precancer while carcinoma in situ is cancer.     

Influence of oral contraception on cytology and histology of the cervix uteri. Population screening for cervical carcinoma in Maribo amt 1967-1969

In this study women using oral contraceptives were compared with those using other contraceptive methods with regard to abnormal cytologic findings of the cervix uteri. 13,125 women were studied, of whom 1471 had used oral contraceptives for an average of 24 months. In 446 women cytologic findings were abnormal; frequency did not differ significantly betweeen users and nonusers of oral contraception. Epithelial dysplasia was found in 69 cases, carcinoma in situ in 236, invasive carcinoma in 45, trichomoniasis in 32, and simple epithelial hyperplasia in 44. No significant difference was found in any group between users and nonusers of oral contraceptives. Classifications as to age, marital status, number of pregnancies, or age at first pregnancy showed similar ratios between users and nonusers. The only variation noted was that women of the middle socioeconomic class had abnormal findings in 4.9% of users compared to 2.8% of nonusers. It was concluded that use of oral contraceptives for an average of 24 months produces no change in the frequency of any abnormal cytologic findings in the cervix uteri.     

Primary malignant melanoma of the vagina and cervix uteri

Summary This report concerns a very rare case of primary malignant melanoma involving the vagina and cervix uteri occurring in a 45-year-old woman. The clinical, light-microscopic and ultrastructural findings are presented and discussed.