Table of Contents
Definition / general | Major updates | WHO (2020) | Board review style question #1 | Board review style answer #1Cite this page: Parra-Herran C. WHO classification. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixWHO.html. Accessed March 29th, 2024.
Definition / general
- The classification below is the updated classification of tumors of the cervix as per the World Health Organization classification of tumors of female reproductive organs, 5th edition (2020)
Major updates
- Squamous lesions:
- Invasive squamous lesions are now classified in 2 main categories: HPV associated and HPV independent
- HPV independent squamous cell carcinomas are rare but their existence is now acknowledged as they may behave more aggressively than the more common HPV associated lesions
- Glandular lesions:
- Both preinvasive and invasive glandular lesions are now classified in 2 main categories: HPV associated and HPV independent
- HPV associated adenocarcinomas can be classified using terminology from previous classification; however, they need to be distinguished, as a group, from HPV independent tumors
- HPV independent adenocarcinomas are most frequently of the gastric type (with both in situ and invasive forms)
- Other distinct types include clear cell and mesonephric carcinomas
WHO (2020)
Squamous epithelial tumors
Glandular tumors and precursors
- Mimics of squamous precursor lesions
- Squamous cell tumors and precursors
Glandular tumors and precursors
- Benign glandular lesions
- Endocervical polyp
- Müllerian papilloma of the uterine cervix
- Nabothian cyst
- Tunnel clusters
- Microglandular hyperplasia
- Lobular endocervical glandular hyperplasia
- Diffuse laminar endocervical hyperplasia
- Mesonephric remnants and hyperplasia
- Arias Stella reaction of the uterine cervix
- Endocervicosis of the uterine cervix
- Tuboendometrioid metaplasia
- Ectopic prostate tissue
- Adenocarcinomas
- Adenocarcinoma in situ, HPV associated, of the uterine cervix
- Adenocarcinoma, HPV associated, of the uterine cervix
- Adenocarcinoma in situ, HPV independent, of the uterine cervix
- Adenocarcinoma, HPV independent, gastric type, of the uterine cervix
- Adenocarcinoma, HPV independent, clear cell type, of the uterine cervix
- Adenocarcinoma, HPV independent, mesonephric type, of the uterine cervix
- Other adenocarcinomas of the uterine cervix
- Other epithelial tumors
- Carcinosarcoma of the uterine cervix
- Adenosquamous and mucoepidermoid carcinomas of the uterine cervix
- Adenoid basal carcinoma of the uterine cervix
- Carcinoma of the uterine cervix, unclassifiable
- Mixed epithelial and mesenchymal tumors
- Germ cell tumors
- Germ cell tumors of the uterine cervix
- Reference: WHO Classification of Tumours Editorial Board: Female Genital Tumours, 5th Edition, 2020
Board review style question #1
According to the latest classification of female genital tumors from the World Health Organization, which is currently a major category in the classification of squamous cell lesions?
- Squamous cell carcinoma, HPV associated
- Basaloid carcinoma
- Ectopic prostatic tissue
- Keratinizing squamous cell carcinoma
- Adenosquamous carcinoma
Board review style answer #1
A. Squamous cell carcinoma, HPV associated. Squamous cell carcinoma of the uterine cervix is now classified as HPV associated and HPV independent. Basaloid and keratinizing are morphologic variants of squamous cell carcinoma but do not represent diagnostic categories. Ectopic prostatic tissue belongs to the category of benign glandular lesions and adenosquamous carcinoma belongs to the category of mixed epithelial tumors.
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Reference: Cervix - WHO classification
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Reference: Cervix - WHO classification