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Pathology and Molecular Diagnosis of Cervical Cancer and Precursor Lesions

  • Mariana CanepaEmail author
  • Nimesh R. Patel
  • Maria Luisa Garcia-Moliner
Chapter

Abstract

Pathologic diagnosis of cervical neoplasia incorporates the practice of cytopathology, molecular pathology, and surgical pathology. Cervical pathology includes preinvasive squamous lesions (squamous intraepithelial lesions/SIL), invasive squamous cell carcinoma, adenocarcinoma in situ, invasive adenocarcinoma, as well as other less common primary epithelial and mesenchymal tumors. The most common cervical lesions are human papillomavirus (HPV)-associated squamous lesions. A two-tiered diagnostic approach classifying preinvasive lesions into low-grade and high-grade squamous intraepithelial lesions is used in cytopathology and surgical pathology. Low-grade squamous intraepithelial lesions (LSIL), which include condylomata, are the result of productive HPV infection that may be transient and regress. High-grade squamous intraepithelial lesions (HSIL) have a greater risk of progression to invasive carcinoma and require further treatment. Adenocarcinoma in situ, a precursor to invasive adenocarcinoma, is also HPV-associated and may coexist with squamous lesions. HPV testing/genotyping has been incorporated into the Papanicolaou cytology screening and helps stratify patients into those needing further evaluation. The incidence of invasive carcinoma has decreased with the widespread use of cytology testing. A subset of tumors not associated with HPV infection, while rare, may present diagnostic challenges, especially in cytology and small biopsies.

Keywords

Classification of cervical tumors Cervical tumor classification HPV and cervical dysplasia/neoplasia Squamous lesions of the cervix Glandular lesions of the cervix Unusual neoplasias of the cervix 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mariana Canepa
    • 1
    Email author
  • Nimesh R. Patel
    • 1
  • Maria Luisa Garcia-Moliner
    • 1
  1. 1.Department of Pathology and Laboratory MedicineBrown University Warren Alpert Medical SchoolProvidenceUSA

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