1. The most common origin of cervical squamous cell carcinoma
Immature squamous metaplasia of endocervix
Mature squamous metaplasia of endocervix

2. In any HPV lesion
Enlarged raisin-like nuclei + perinuclear halo

3. These lesions are caused by HPV 16,18…etc.
nuclear enlargement, hyperchromasia (dark staining), coarse chromatin granules, and
variation in nuclear size and shape (pleomorphism), loss of maturation and increased mitoses
This clearing is normal & it is due to glycogen
In lower third
In lower 2 thirds
In full thiscness but the BM is intact
= carcinoma in situ
= HSIL (high grade squamous intraepithelial lesion)
= LSIL (low grade squamous intraepithelial lesion)

4. Name for a stain that is good for nuclear details
= cervical smear cytology
Enlarged nucleus, irregular nuclear contours & abnormal chromatin
Changes worse than LSIL

5. Invasive squamous cell carcinoma
Keratin pearl
Islands of atypical squamous cells are infiltrating the stroma

6. Same notes as slide 5

7. Same notes as slide 5

8. Normal proliferative endometrium
…the gland/stroma ratio is normal
…the glands are regular and rounded
Simple cystic hyperplasia:
The glands are cystically dilated and crowded with decreased stroma and increased gland/stroma ratio
Surface epithelium

9. Complex hyperplasia:
The glands are branched, irregular and crowded with decreased stroma and increased gland/stroma ratio

10. Simple hyperplasia without atypia
Complex hyperplasia without atypia
Atypia here: enlarged vacuolated nucleus with prominent nucleolus
Complex hyperplasia with atypia
Complex hyperplasia with atypia…high power

11. …marked architectural disturbance (most important) + atypia
Endometrioid carcinoma
Cribriforming: 1 large structure with multiple glandular spaces inside
The glands are fused
…marked architectural disturbance (most important) + atypia

12. Same notes as slide 11

13. Same notes as slide 11

14. Same notes as slide 11
Note that the malignant glands invade this stroma
(feature of cancer)

15. Same notes as slide 11

16. few areas still contain glands
This is high grade endometrioid carcinoma…sheets of cells (not forming glands)…poorly differentiated

17. Main 2 types of endometrial cancer

18. Serous endometrial intraepithelial carcinoma
Papillae of serous endometrial carcinoma (it is commonly papillary and high grade by definition)

19. Endometriosis (this example is in colon)
Endometrial glands & stroma that form a polyp in colon
Colonic mucosa

20. Endometriosis (this example is in colon)
…high power
Endometrial glands & stroma
Colonic mucosa

21. Endometriosis somewhere

22. Leiomyomata
A bisected uterus showing multiple well-circumscribed masses in its wall…
The masses are white to yellow with hard whorly cut surface
…multiplicity is toward benign more

23. Leiomyoma
…smooth muscle cells
…benign because the criteria that depend on tumor necrosis, atypia & mitotic rate are not matched here

24. Leiomyosarcoma
…this is an area of a tumor the features of which matched the criteria of malignancy
…note the marked atypia & high mitotic rate
Inside circles are mitoses

25. Thank You