Squamous Lesions of the Cervix

Abstract

Many neoplastic and preneoplastic lesions of the cervix are related to human papillomavirus (HPV) infection, particularly the high-risk ­subtypes. Squamous papillomas are benign proliferation of squamous epithelium and are related to low-risk HPV subtypes. Condyloma acuminatum is a manifestation of HPV infection, mostly in low-risk groups (HPV 6 and 11). Cervical intraepithelial neoplasia (CIN) 1 can harbor both the high- and low-risk subtypes of HPV. High-grade CIN (CIN 2 and 3) and invasive squamous cell carcinoma (SCC) are caused by high-risk HPV (HPV 16 and 18) and are associated with integrated viral genome. Primary adenocarcinomas of the cervix are associated with high-risk HPV infection in most, if not all, cases. The histologic spectrum of cervical adenocarcinomas includes usual endocervical adenocarcinoma, endometrioid carcinoma, and intestinal mucinous carcinoma, each of them may be accompanied by their corresponding in situ lesions. Rare variants include minimal deviation adenocarcinoma (adenoma malignum), villoglandular adenocarcinoma, adenosquamous carcinoma, adenobasal cell carcinoma, serous carcinoma, clear cell carcinoma, and neuroendocrine carcinomas.