CERVICAL CANCERPATHOLOGY

CLINICAL FEATURES INVESTIGATIONS

R.NARAYANEEII OG UNIT

PROF.HAROLD ZUR HAUSEN

TADPOLE CELL

PATHOLOGICAL TYPES OF CERVICAL CARCINOMAS

SQUAMOUS CELL CARCINOMA- 85% ADENOCARCINOMA- 15% ADENOSQUAMOUS CARCINOMA NEUROENDOCRINE CARCINOMAS 5%

SQUAMOUS CELL CARCINOMA

• PROLIFERATIVE GROWTH• ULCERATIVE• FLAT INDURATED AREAS

MORPHOLOGY

MODE OF SPREAD

• DIRECT SPREAD

• LYMPHATIC SPREAD

• VASCULAR SPREAD

FEATURES IN EARLY INVASIVE STAGE

AGE 35-45 YEARSMENORRHAGIAMENOMETRORRHAGIAPOSTCOITAL BLEED, PAINBLOOD STAINED LEUCORRHOEA WITH

OFFENSIVE ODOUR

FEATURES IN ADVANCED DISEASE

PELVIC PAINANEMIA

ANOREXIACACHEXIA

OLIGURIA, FEATURES OF UREMIASYMPTOMS OF METASTASIS TO

OTHER ORGANS

ON EXAMINATION

FRIABLE GROWTH AND/OR ULCER IN CERVIX –BLEEDS ON TOUCH

INDURATION CAN BE FELTBULKY UTERUS IN ADVANCED STAGESTHICKENED INDURATION OF UTEROSACRAL

LIGAMENTS ON RECTAL EXAMINATION

INVESTIGATIONS• TO CONFIRM THE DIAGNOSIS, PUNCH BIOPSY

OF THE LESION• FOR HISTOLOGICAL SUBTYPE• DIFFERENTIATION OF THE TUMOUR CELLS

INVASIVE SQUAMOUS CELL CARCINOMA

MICROINVASIVE CARCINOMA

WELL DIFFERENTIATED SQUAMOUS CELL CARCINOMA

MODERATELY DIFFERENTIATED SQUAMOUS CELL CARCINOMA

INVESTIGATIONS

COMPLETE HEMOGRAMURINALYSISBLOOD GLUCOSELIVER AND RENAL FUNCTION TESTSSERUM ELECTROLYTESBLOOD GROUPING AND TYPINGECG

INVESTIGATIONS

STAGING IS ESSENTIALLY BASED ON CLINICAL FINDINGS..BUT THE FOLLOWING INVESTIGATIONS HELP IN FINALISING THE STAGE

CYSTOSCOPYPROCTOSCOPY IV PYELOGRAMCHEST X-RAYCT , MRIPET SCANFDG-PET

FDG-PET IN ADVANCED CARCINOMA CERVIX

INTRAVENOUS PYELOGRAPHY SHOWING B/L MEGAURETER AND CALYCEAL DILATATION

CANNON BALLS

CANNON BALL SECONDARIES LUNG

THANK YOU