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Adenocarcinoma of cervix

Reviewer: Marilin Rosa, M.D., University of Florida (see Reviewers page)
Revised: 17 May 2011, last major update May 2011
Copyright: (c) 2006-2011, PathologyOutlines.com, Inc.


● Endocervical glandular lesion characterized by high grade cytology, nuclear enlargement, mitosis and stromal invasion (The Bethesda System for Reporting Cervical Cytology (2nd Ed); Springer, 2005)


● Associated with HPV infection, particularly HPV 16/18 (Mod Pathol 2005;18:528)


● Multilayering
● May form glandular structures with central lumina or acinar formations with peripheral nuclei
● Cells are pleomorphic, large or small with fluffy cytoplasm, cytoplasmic vacuolization, loss of nuclear polarity, true nuclear crowding, nuclei with clumped chromatin, marked variation of nucleoli, occasional mitotic figures
● Invasion is often characterized by heavy blood with abundant glandular epithelium, even without tumor diathesis or fully malignant nuclear criteria (Cancer 2002;96:5)
● May see morules (also seen with mesothelial cells, benign and malignant lesions)
Endocervical adenocarcinoma: usually columnar with granular cytoplasm, rosettes, sheets with holes vs. balls, round plump cells, molded groups
● Conventional smears that are false negative often have fewer and smaller abnormal cells, small nuclei, less atypia and less hyperchromasia (Arch Pathol Lab Med 2006;130:23)

Cytology images

Various images:

With repair-like features

Adenocarcinoma misdiagnosed as repair

Positive stains

● p16 is useful to diagnose adenocarcinoma of the cervix (Am J Surg Pathol 2003;27:187)
● To distinguish endometrial and endocervical adenocarcinoma, a panel of immunostains including vimentin, ER, p16, and CEA is useful (Int J Gynecol Pathol 2002;21:11)

End of Cervix-cytology > Carcinoma > Adenocarcinoma of cervix

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