Abstract
The uterus is best divided into corpus, isthmus, and cervix. The cervix (term taken from the Latin, meaning neck) is the most inferior portion of the uterus, protruding into the upper vagina. The transition between the endocervix and the lower portion of the uterine corpus is termed the isthmus or lower uterine segment. The latter is used for descriptive purposes during gestation and labor and is an important landmark for the pathologist when describing cancers of the uterine corpus. The muscular layer in the region of the isthmus is less well developed than in the corpus, a feature that facilitates effacement and dilation during labor. The vagina is fused circumferentially and obliquely to the distal part of the cervix and is divided into an upper, supervaginal, and lower vaginal portion.28 The cervix measures 2.5–3.0 cm in length in the adult nulligravida, and when normally positioned it is angled slightly downward and backward. The vaginal portion (portio vaginalis) of the cervix, also referred to as the exocervix, is delimited by the anterior and posterior vagina fornices and has a convex elliptical surface. The portio may be divided into anterior and posterior lips, of which the anterior is shorter and projects lower than the posterior lip. In the center of the exocervix is the external os. This external os is circular in the nulligravida and slit-like in the parous woman (Fig. 5.1). The external os is connected with the isthmus of the uterus by the cervical canal (endocervix). The canal is an elliptical cavity, measuring 8 mm in its greatest diameter and contains longitudinal mucosal ridges, the plicae palmatae (Fig. 5.2).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Averette HE, Weinstein GD, Frost P (1970) Autoradiographic analysis of cell proliferation kinetics in human genital tissues. I. Normal cervix and vagina. Am J Obstet Gynecol 108: 8–17
Berchuck A, Rodriguez G, Kamel A, Soper JT, Clarke-Pearson DL, Bast RC Jr (1990) Expression of epidermal growth factor receptor and HER-2/Neu in normal and neoplastic cervix, vulva, and vagina. Obstet Gynecol 76: 381–387
Blomhoff R, Green MH, Berg T, Norum KR (1990) Transport and storage of vitamin A. Science 250: 399–404
Chretien FC, Gernigon C, David G, Psychoyos A (1973) The ultrastructure of human cervical mucus under scanning electron microscopy. Fertil Steril 24: 746–757
Chytil F, Ong DE (1987) Intracellular vitamin A-binding proteins Annu Rev Nutr 7: 321–335
Coppleson M, Reid BL (1967) Preclinical carcinoma of the cervix uteri. Oxford, Pergamon Press
Coppleson M, Pixley E, Reid BL (1971) Colposcopy. A scientific and practical approach to the cervix in health and disease. Springfield, 111, Charles C Thomas
Czernobilsky B, Moll R, Franke WW, et al (1984) Intermediate filaments of normal and neoplastic tissues of the female genital tract with emphasis on problems of differential tumor diagnosis. Pathol Res Pract 179: 31–37
Fand SB (1973) The histochemistry of human cervical epithelium. In: Blandau RJ, Moghissi KS (eds) The biology of the cervix. Chicago, University of Chicago Press, pp 103–24
Feldman D, Romney SL, Edgcomb J, Valentine T (1984) Ultrastructure of normal, metaplastic and abnormal human uterine cervix: use of montages to study the topographical relationship of epithelial cells. Am J Obstet Gynecol 150: 573–688
Ferenczy A, Richart RM (1974) Female reproductive system. Dynamics of scan and transmission electron microscopy. New York, John Wiley amp; Sons
Fetissof F, Berger G, Dubois MP, et al (1985) Endocrine cells in the female genital tract. Histopathology 9: 133–145
Fluhman CF (1961) The cervix uteri and its diseases. Philadelphia, WB Saunders
Foraker AG, Marino GA (1961) Glycogen-synthesizing enzymes in the uterine cervix. Obstet Gynecol 17: 311–315.
Foraker AG, Wingo WJ (1956) Protein-bound sulfhydryl and disulfide group in squamous carcinoma of the uterine cervix. Am J Obstet Gynecol 71: 1182
Fox H, Kazzaz B, Langley FA (1964) Argyrophil and argentaffin cells in the female genital tract and in ovarian mucinous cysts. J Pathol Bacteriol 88: 479–488
Franke WW, Moll R, Achtstaetter T, Kuhn C (1986) Cell typing of epithelial and carcinomas of the female genital tract using cytoskeletal proteins as markers. In Peto R (ed) Banbury Reports 21, cervical cancer, pp 121-144
Friedrich ER (1973) The normal morphology and ultrastructure of the cervix. In: Blandau RJ, Moghissi KS (eds) The biology of the cervix. Chicago, University of Chicago Press, pp 79–102
Fuchs EV, Coppock SM, Green H, Cleveland DW (1981) Two distinct classes of keratin genes and their evolutionary significance. Cell 27: 75–84
Gould PR, Barter RA, Papadimitriou JM (1979) An ultrastructural, cytochemical and autoradiographic study of the mucous membrane of the human cervical canal with reference to subcolumnar cells. Am J Pathol 95: 1–16
Graham S (1984) Epidemiology of retinoids and cancer. J Natl Cancer Inst 73: 1423–1428
Hillemanns P, Tannous-Khuri L, Koulos JP, Talmadge DA, Wright TC (1992) Localization of cellular retinoid-binding proteins in human cervical intraepithelial neoplasia and invasive carcinoma. Am J Pathol 141: 973–979
Hughes RG, Norval M, Howie SEM (1988) Expression of major histocompatibility class II antigens by Langerhans cells in cervical intraepithelial neoplasia. J Clin Pathol 41: 253
Johnson LD (1973) Dysplasia and carcinoma in-situ in pregnancy. In: Noms HJ, Hertig AT, Abell MR (eds) The uterus. International Academy of Pathology Monographs. Baltimore, Williams amp; Wilkins, pp 382–412
Kolstad P, Stafl A (1977) Atlas of colposcopy, 2nd ed. Baltimore, University Park Press
Konishi I, Fujii S, Nonogaki H, Nanbu Y, Iwai T, Mori T (1991) Immunohistochemical analysis of estrogen receptors, progesterone receptors, Ki-67 antigen, and human papillo-mavirus DNA in normal and neoplastic epithelium of the uterine cervix. Cancer 68: 1340–1350
Koss LG (1979) Diagnostic cytology and its histopathologic bases, 3rd ed. Philadelphia, J Lippincott
Krantz KE (1973) The anatomy of the human cervix, gross and microscopic. In: Blandau RJ, Moghissi K (eds) The biology of the cervix. Chicago, University of Chicago Press
Kupryjánczyk J (1990) Epidermal growth factor receptor expression in the normal and inflamed cervix uteri: a comparison with estrogen receptor expression. Int J Gynecol Pathol 9: 263–271
Kupryjánczyk J, Möller P (1988) Estrogen receptor distribution in the normal and pathologically changed human cervix uteri: an immunohistochemical study with use of monoclonal anti-ER antibody. Int J Gynecol Pathol 7: 75–85
Linhartova A (1978) Extent of columnar epithelium on the ectocervix between the ages of 1 and 13 years. Obstet Gynecol 52: 451–456
Mangelsdorf DJ, Ong ES, Dyck JA, Evans RM (1990) Nuclear receptor that identifies a novel retinoic acid response pathway. Nature 345: 224–229
Marno T, Yamasaki M, Ladines-Llave CA, Mochizuki M (1992) Immunohistochemical demonstration of elevated expression of epidermal growth factor receptor in the neoplastic changes of cervical squamous epithelium. Cancer 69: 1182–1187
Meyer R (1941) The basis of the histological diagnosis of carcinoma with special reference to carcinoma of the cervix and similar lesions. Surg Gynecol Obstet 73: 14
Miller CJ, McChesney M, Moore PF (1992) Langerhans cells, microphages and lymphocyte subsets in the cervi and vagina of rhesus macaques. Lab Invest 67: 628–634.
Mittal K, Pearson J, Demopoulos R (1990) Patterns of mRNA for epidermal growth factor receptor and keratin B-2 in normal cervical epithelium and in cervical intraepithelial neoplasia. Gynecol Oncol 38: 224–229
MoU R, Franke WW, Schiller DL, Geiger B, Krepier R (1982) The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell 31: 11–24
Moll R, Levy R, Czernobilsky B, Hohlweg-Majert P, et al. (1983) Cytokeratins of normal epithelia and some neoplasms of the female genital tract. Lab Invest 49: P599–610
Naftolin F, Stubblefield PG (eds) (1980) Dilatation of the uterine cervix. Connective tissue biology and clinical management. New York, Raven Press
Nielsen LN, H0rding U, Daugaard S, Rasmussen LP, Norrild B (1991) Cytokeratin intermediate filament pattern and human papillomavirus type in uterine cervical biopsies with different histological diagnosis. Gynecol Obstet Invest 32: 232–238
Nogogaki H, Fujii S, Konishi I, Nanbu Y, Ozaki S, Ishikawa Y, Mori T (1990) Estrogen receptor localization in cervical neoplasia. Cancer 66: 26620
Odeblad E (1968) The functional structure of human cervical mucus. Acta Obstet Gynecol Scand 47 (Suppl 1): 57–79
Press MF, Nousek-Goebl NA, Bur M, Greene GL (1986) Estrogen receptor localization in the female genital tract. Am J Pathol 123: 280–92
Reiffenstuhl G (1964) The lymphatics of the female genital organs. Philadelphia, JB Lippincott
Richart RM (1973) Cervical intraepithelial neoplasia. In: Sommers SC (ed) Pathology annual. New York, Appleton-Century-Crofts, pp 301–328
Robboy SJ, Taguchi O, Cunha GR (1982) Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethyl-stilbesterol. Hum Pathol 13: 190–198
Romney SL, Dwyer A, Slagle S, et al (1985) Chemoprevention of cervix cancer; Phase I-II: a feasibility study involving the topical vaginal administration of retinyl acetate gel. Gynecol Oncol 20: 109–119
Roncalli M, Sideri M, Giè P, Servida E (1988) Immunophe-notypic analysis of the transformation zone of human cervix. Lab Invest 58: 141–149
Serra V, Ramirez AA, Lara C, Marzo C, Castells A, Bonilla-Musoles F (1990) Distribution of involucrin in normal and pathological human uterine cervix. Gynecol Oncol 36: 34–42
Singer A (1976) The cervical epithelium during pregnancy and the puerperium. In: Jordan JA, Singer A (eds) The Cervix London, WB Sanders, p 105
Smedts F, Ramaekers F, Troyanovsky S, et al (1992) Basalcell keratins in cervical reserve cells and a comparison to their expression in cervical intraepithelial neoplasia. Am J Pathol 140: 601–612
Tutsumi K, Sun Q, Yasumoto S (1993) In vitro and in vivo analysis of cellular origin of cervical squamous metaplasia. Am J Pathol 143(4): 1150–1158
Vecchia C, Franceschi S, Decarli A, et al (1984) Dietary vitamin A and the risk of invasive cervical cancer. Int J Cancer 34: 319
Warhol MJ, Anatonioli DA, Pinkus GS, et al (1992) Immu-noperoxidase staining for involucrin: a potential diagnostic aid in cervicovaginal pathology. Hum Pathol 13: 1095
Wolbach SB, Howe PR (1932) Epithelial repair in recovery of vitamin A deficiency. An experimental study. J Exp Med 57: 511
Wolbach SB, Howe PR (1925) Tissue changes following deprivation of fat-soluble A vitamin. J Exp Med 42: 753–777.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer Science+Business Media New York
About this chapter
Cite this chapter
Ferenczy, A., Wright, T.C. (1994). Anatomy and Histology of the Cervix. In: Kurman, R.J. (eds) Blaustein’s Pathology of the Female Genital Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3889-6_5
Download citation
DOI: https://doi.org/10.1007/978-1-4757-3889-6_5
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4757-3891-9
Online ISBN: 978-1-4757-3889-6
eBook Packages: Springer Book Archive