Histology (normal)

Cervix
General
Histology (normal)

Authors: Jaya Ruth Asirvatham, M.B.B.S., Sharon Liang, M.D., Ph.D.

Topic Completed: 1 June 2013

Revised: 26 December 2019

Revised: 20 December 2018, last major update June 2013

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: cervix histology[title]

Page views in 2019: 16,847

Page views in 2020 to date: 875

Table of Contents

Definition / general | Diagrams / tables | Clinical images | Microscopic (histologic) images | Cytology description

Cite this page: Asirvatham J. Histology (normal). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixnormalhistology.html. Accessed January 24th, 2020.

Definition / general

Most of cervix is composed of fibromuscular tissue
Epithelium is either squamous or columnar
Endocervix: lined by columnar epithelium that secretes mucus; epithelium has complex infoldings that resemble glands or clefts on cross section; mucosa rests on inconspicuous layer of reserve cells
Ectocervix (exocervix): covered by nonkeratinizing, stratified squamous epithelium, either native or metaplastic; has basal, midzone and superficial layers; after menopause is atrophic with mainly basal and parabasal cells with high N/C ratio that resembles dysplasia; prepubertal girls have similar appearing epithelium
Squamocolumnar (SC) junction: where squamous and columnar epithelium meets; lined by krt7+ non-stratified cuboidal cells; can migrate proximately as columnar epithelium is replaced by metaplastic squamous epithelium, due to increased estrogen production and growth of vaginal bacterial flora (new SC junction); recent studies support SC junction as site of “embryonic cell population”, involved in cervical remodeling (metaplasia and microglandular hyperplasia), and as cell of origin for cervical cancer and its precursors (J Pathol 2013;229:460)
Transformation zone: also called ectropion, area between original SC junction and new SC junction due to regenerative metaplastic response; site of > 90% of squamous cell carcinomas and dysplasia
Note: endocrine cells and melanocytes are seen occasionally in cervix; multinucleated giant cells may be a normal finding, often accompanied by edema (Arch Pathol Lab Med 1985;109:200)
Basal cells (reserve cells): derived from SC junction cells (J Pathol 2013;229:460); cuboidal to low columnar with scant cytoplasm and round/oval nuclei; acquire eosinophilic cytoplasm as they mature; positive for low molecular weight keratin (krt5) and estrogen receptor; negative for high molecular weight keratin and involucrin
Suprabasal cells: have variable amount of glycogen, detectable with Lugol/Schiller’s test (application of iodine) or microscopically by PAS stain; positive for high molecular weight keratin (p63) and involucrin
Glandular epithelium: positive for estrogen receptor
Menarche: ovaries produce estrogen, which stimulates glycogen update by cervical and vaginal mucosa, which promotes growth of endogenous vaginal microorganisms, which produce acid and drop in vaginal pH; basal/reserve cells respond by proliferating, causing squamous and columnar metaplasia; squamous epithelium overgrows columnar epithelium, obstructing crypt openings and forming Nabothian cysts; also produces acute and chronic inflammatory infiltrate