Pathology of Cervical Lesions

  • Pranab Dey


The present chapter describes the non-neoplastic and neoplastic lesions of the uterine cervix with the help of multiple illustrations. The non-neoplastic lesions of the cervix includes various inflammatory lesions, infective conditions, benign squamous cell lesions (such as squamous metaplasia, condyloma acuminatum, squamous papilloma), and tumour-like lesions (endocervical polyp, Nabothian cyst, tunnel clusters, microglandular hyperplasia, endocervical glandular hyperplasia). The pre-neoplastic and neoplastic lesions of the cervix includes precursors of carcinomas, squamous epithelial tumours, glandular epithelial tumours, neuroendocrine tumours, mesenchymal tumours, mixed epithelial and mesenchymal tumours, melanocytic tumours, germ cell tumours, lymphoid and myeloid tumours and various metastatic tumours. The cytological features, gross appearance, histopathological features and immunohistochemistry of these lesions are discussed with illustrations.


Squamocolumnar junction Transformation zone Cervicitis Herpes simplex Low grade squamous intraepithelial lesion High grade squamous intraepithelial lesion Squamous cell carcinoma Minimally invasive carcinoma Mimicker of invasion Papillary squamous cell carcinoma Basal cell carcinoma Glassy cell carcinoma Squamous metaplasia Immature metaplasia condyloma accuminatum Squamous papilloma Atypical glandular cell of undetermined significance Adenocarcinoma in situ Microinvasive carcinoma Mucinous carcinoma Minimal deviation adenocarcinoma Endometrioid type adenocarcinoma of cervix Clear cell carcinoma of cervix Serous carcinoma of cervix Mesonephric carcinoma Villoglandular carcinoma Neuroendocrine tumours of cervix Endocervical polyp Nabothian cyst Endocervical glandular hyperplasia Microglandular hyperplasia Tunnel clusters Arias Stella reaction Leiomyosarcoma Leiomyoma Rhabdomyosarcoma Endometrial stromal sarcoma Adenomyoma Adenosarcoma Carcinosarcoma Lymphoma of cervix Malignant melanoma of cervix 


  1. 1.
    Kurman RJ, Carcangiu ML, Herrington S, Young RH. Tumours of the uterine cervix. In: WHO classification of tumours of female genital reproductive organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014.Google Scholar

Suggested Reading

  1. Ahmad AK, Hui P, Litkouhi B, Azodi M, Rutherford T, McCarthy S, Xu ML, Schwartz PE, Ratner E. Institutional review of primary non-hodgkin lymphoma of the female genital tract: a 33-year experience. Int J Gynecol Cancer. 2014;24(7):1250–5.CrossRefGoogle Scholar
  2. Alfsen GC, Kristensen GB, Skovlund E, Pettersen EO, Abeler VM. Histologic subtype has minor importance for overall survival in patients with adenocarcinoma of the uterine cervix: a population-based study of prognostic factors in 505 patients with nonsquamous cell carcinomas of the cervix. Cancer. 2001;92(9):2471–83.CrossRefGoogle Scholar
  3. Anand M, Deshmukh SD, Gulati HK. Papillary squamotransitional cell carcinoma of the uterine cervix: a histomorphological and immunohistochemical study of nine cases. Indian J Med Paediatr Oncol. 2013;34(2):66–71.CrossRefGoogle Scholar
  4. Binesh F, Karimi Zarchi M, Vahedian H, Rajabzadeh Y. Primary malignant lymphoma of the uterine cervix. BMJ Case Rep. 2012;2012.Google Scholar
  5. Chen TD, Chuang HC, Lee LY. Clinicopathologic features of 12 cases with reference to CD117 expression. Int J Gynecol Pathol. 2012;31(1):25–32.CrossRefGoogle Scholar
  6. Ditto A, Martinelli F, Carcangiu M, Solima E, de Carrillo KJ, Sanfilippo R, Haeusler E, Raspagliesi F. Embryonal rhabdomyosarcoma of the uterine cervix in adults: a case report and literature review. J Low Genit Tract Dis. 2013;17(4):e12–7.CrossRefGoogle Scholar
  7. Doshi B, Shetty S, Safaya A. Leiomyosarcoma of cervix. J Obstet Gynaecol India. 2013;63(3):211–2.CrossRefGoogle Scholar
  8. Farley JH, Hickey KW, Carlson JW, Rose GS, Kost ER, Harrison TA. Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma. Cancer. 2003;97(9):2196–202.CrossRefGoogle Scholar
  9. Fluhmann CF. Focal hyperplasia (tunnel clusters) of the cervix uteri. Obstet Gynecol. 1961;17:206–14.PubMedGoogle Scholar
  10. Gilks CB, Young RH, Aguirre P, DeLellis RA, Scully RE. Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix. A clinicopathological and immunohistochemical analysis of 26 cases. Am J Surg Pathol. 1989;13(9):717–29.CrossRefGoogle Scholar
  11. Ganesan R, Hirschowitz L, Dawson P, Askew S, Pearmain P, Jones PW, Singh K, Chan KK, Moss EL. Neuroendocrine carcinoma of the cervix: review of a series of cases and correlation with outcome. Int J Surg Pathol. 2016;24(6):490–6.CrossRefGoogle Scholar
  12. Greeley C, Schroeder S, Silverberg SG. Microglandular hyperplasia of the cervix: a true “pill” lesion? Int J Gynecol Pathol. 1995;14:50–4.CrossRefGoogle Scholar
  13. Hasegawa K, Nagao S, Yasuda M, Millan D, Viswanathan AN, Glasspool RM, Devouassoux-Shisheboran M, Covens A, Lorusso D, Kurzeder C, Kim JW, Gladieff L, Bryce J, Friedlander M, Fujiwara K. Gynecologic Cancer InterGroup (GCIG) consensus review for clear cell carcinoma of the uterine corpus and cervix. Int J Gynecol Cancer. 2014;24(9 Suppl 3):S90–5.CrossRefGoogle Scholar
  14. Hasiakos D, Papakonstantinou K, Kondi-Paphiti A, Fotiou S. Low-grade endometrial stromal sarcoma of the endocervix. Report of a case and review of the literature. Eur J Gynaecol Oncol. 2007;28(6):483–6.PubMedGoogle Scholar
  15. Huang PS, Chang WC, Huang SC. Müllerian adenosarcoma: a review of cases and literature. Eur J Gynaecol Oncol. 2014;35(6):617–20.PubMedGoogle Scholar
  16. Kalof AN, Cooper K. Our approach to squamous intraepithelial lesions of the uterine cervix. J Clin Pathol. 2007;60(5):449–55.CrossRefGoogle Scholar
  17. Koyfman SA, Abidi A, Ravichandran P, Higgins SA, Azodi M. Adenoid cystic carcinoma of the cervix. Gynecol Oncol. 2005;99(2):477–80.CrossRefGoogle Scholar
  18. Lataifeh IM, Al-Hussaini M, Uzan C, Jaradat I, Duvillard P, Morice P. Villoglandular papillary adenocarcinoma of the cervix: a series of 28 cases including two with lymph node metastasis. Int J Gynecol Cancer. 2013;23(5):900–5.CrossRefGoogle Scholar
  19. Maniar KP, Nayar R. HPV-related squamous neoplasia of the lower anogenital tract: an update and review of recent guidelines. Adv Anat Pathol. 2014;21(5):341–58.CrossRefGoogle Scholar
  20. Martin CM, O’Leary JJ. Histology of cervical intraepithelial neoplasia and the role of biomarkers. Best Pract Res Clin Obstet Gynaecol. 2011;25(5):605–15.CrossRefGoogle Scholar
  21. McCluggage WG. New developments in endocervical glandular lesions. Histopathology. 2013;62(1):138–60.CrossRefGoogle Scholar
  22. McCluggage WG, Sumathi VP, McBride HA, Patterson A. A panel of immunohistochemical stains, including carcinoembryonic antigen, vimentin, and estrogen receptor, aids the distinction between primary endometrial and endocervical adenocarcinomas. Int J Gynecol Pathol. 2002;21(1):11–5.CrossRefGoogle Scholar
  23. Mount S, Evans MF, Wong C, et al. Human papillomavirus induced lesions of the cervix: a review and update on the grading of cervical dysplasia. Pathol Case Rev. 2003;8:145–51.Google Scholar
  24. Mulvany NJ, Monostori SJ. Adenoma malignum of the cervix: a reappraisal. Pathology. 1997;29(1):17–20.CrossRefGoogle Scholar
  25. Niu X, Gilbert L. Neuroendocrine carcinoma of the uterine cervix: a single institution case review. Eur J Gynaecol Oncol. 2011;32(4):377–80.PubMedGoogle Scholar
  26. Nucci MR. Symposium part III: tumour-like glandular lesions of the uterine cervix. Int J Gynecol Pathol. 2002;21(4):347–59.CrossRefGoogle Scholar
  27. Nucci MR, Clement PB, Young RH. Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive pseudoneoplastic lesion and comparison with fourteen cases of adenoma malignum. Am J Surg Pathol. 1999;23:886–91.CrossRefGoogle Scholar
  28. Nucci MR, Crum CP. Redefining early cervical neoplasia: recent progress. Adv Anat Pathol. 2007;14:1–10.CrossRefGoogle Scholar
  29. Omranipour R, Mahmoodzadeh H, Jalaeefar A, Abdirad A, Parsaei R, Ebrahimi R. Primary malignant melanoma of uterine cervix. J Obstet Gynaecol. 2014;34(1):111.CrossRefGoogle Scholar
  30. Ostör AG. Early invasive adenocarcinoma of the uterine cervix. Int J Gynecol Pathol. 2000;19(1):29–38.CrossRefGoogle Scholar
  31. Östör AG, Duncan A, Quinn M, Rome R. Adenocarcinoma in situ of the uterine cervix: an experience with 100 cases. Gynecol Oncol. 2000;79:207–10.CrossRefGoogle Scholar
  32. Reig Castillejo A, Membrive Conejo I, Foro Arnalot P, Rodríguez de Dios N, Algara López M. Neuroendocrine small cell carcinoma of the uterine cervix. Clin Transl Oncol. 2010;12(7):512–3.CrossRefGoogle Scholar
  33. Ronnett BM. Endocervical adenocarcinoma: selected diagnostic challenges. Mod Pathol. 2016;29(Suppl 1):S12–28.CrossRefGoogle Scholar
  34. Sharma NK, Sorosky JI, Bender D, Fletcher MS, Sood AK. Malignant mixed mullerian tumour (MMMT) of the cervix. Gynecol Oncol. 2005;97(2):442–5.CrossRefGoogle Scholar
  35. Tamimi HK, Ek M, Hesla J, Cain JM, Figge DC, Greer BE. Glassy cell carcinoma of the cervix redefined. Obstet Gynecol. 1988;71(6 Pt 1):837–41.PubMedGoogle Scholar
  36. Togami S, Kasamatsu T, Sasajima Y, Onda T, Ishikawa M, Ikeda S, Kato T, Tsuda H. Serous adenocarcinoma of the uterine cervix: a clinicopathological study of 12 cases and a review of the literature. Gynecol Obstet Investig. 2012;73(1):26–31.CrossRefGoogle Scholar
  37. Tseng CJ, Pao CC, Tseng LH, Chang CT, Lai CH, Soong YK, Hsueh S, Jyu-Jen H. Lymphoepithelioma-like carcinoma of the uterine cervix: association with Epstein-Barr virus and human papillomavirus. Cancer. 1997;80(1):91–7.CrossRefGoogle Scholar
  38. Zaino RJ. Symposium part I: adenocarcinoma in situ, glandular dysplasia, and early invasive adenocarcinoma of the uterine cervix. Int J Gynecol Pathol. 2002;21(4):314–26.CrossRefGoogle Scholar
  39. Zhou C, Gilks CB, Hayes M, Clement PB. Papillary serous carcinoma of the uterine cervix: a clinicopathologic study of 17 cases. Am J Surg Pathol. 1998;22(1):113–20.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Pranab Dey
    • 1
  1. 1.Post Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

Personalised recommendations