NON-KERATINIZING SQUAMOUS CELL CARCINOMA OF THE CERVIX
DISTINCTIVE FEATURES
One of the most common tumors in women.
Peak incidence at age 40-45.
Usually preceded by cervical intraepithelial neoplasia (CIN).
Increased incidence with the first intercourse at an early age, multiple partners, and high risk sex partners.
Increased incidence with human papillomavirus (HPV) infection (types 16, 31,32,35,39).
Precursors include:
CIN I (including condyloma) in which the atypia is seen in the superficial cells (koilocytotic atypia). The maturation of the epithelium is intact.
CIN II in which the epithelial atypia is seen in basal cells and the overlying cells. The atypical epithelium is occypying less than 50% of the thickness of the epithelium. The maturation of the epithelium is partially disturbed.
CIN III in which the the atypia is seen in all the cell layers of the epithelial lining. Mitotic figures can be seen in the upper 1/2 of the epithelium. The maturation of the epithelium is minimal to absent.
Grossly the invasive tumor may be exophytic, ulcerating, fungating or infiltrating.
Tumor is composed of squamous cells that are arranged in sheets and islands. The well differentiated tumors exhibit keratin pearls. keratin pearls are difficult to find in the poorly differentiated tumors.