Basics

Question 1

Risk factors

Answer 1

Prior history of STDs, early age of first coitus, multiple sexual partners, multiparity, nonbarrier methods of birth control, smoking. ??immunocompromised

Question 2

Spread pattern

Answer 2

Local

LN – usually sequential – parametrial LN, pelvic, common iliac, para-aortic and then scalene

Question 3

What imaging needed

Answer 3

Imaging: CT and MRI

Question 4

What Ex info needed?

Answer 4

Ex: parametrium, proctoscopy and cystoscopy

Question 5

Histology types

Answer 5

Squamous (85%)
Adeno (15%)
verrucous carcinoma
adenosquamous
clear cell
neuroendocrine
undiff

Question 6

Adenocarcinoma

Answer 6

Adeno: 15% no visible lesion, often stain CEA+

Question 7

Verrucous

Answer 7

Verrucous: well-differentiated. Local recurrence, does not metastasize. Associated with HPV 6. Historically, has been thought that use of radiation as treatment can cause anaplastic transformation but ?? now

Question 8

Adenosquamous:

Answer 8

Adenosquamous: glandular/squamous origin. acts like adeno

Question 9

Glassy cell:

Answer 9

Glassy cell: poor differentiation (adenosquamous)

Question 10

Clear cell:

Answer 10

Clear cell: poor differentiation. Nodular and reddish in gross appearance. Linked to in-utero DES exposure (Diethylstilbestrol)

Question 11

Neuroendocrine:

Answer 11

Neuroendocrine: Small cell, large cell, carcinoid

Question 12

Papillary sq cell:

Answer 12

Papillary sq cell: SCC variant. Looks like transitional or cuboidal cells on microscopy

Question 13

Mesonephric adeno:

Answer 13

Mesonephric adeno: occasionally see remnants of the mesonephric ducts laterally – PAS +

Question 14

What immunohistochemistry is associated with HPV

Answer 14

p16 is a surrogate marker for the presence of high-risk HPV.