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Summary Lecture 3 + 4 - Cervical Cancer

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Lecture 3 4 - Cervical Cancer

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Principles and practice of Human Pathology – Lecture 3 + 4 (20-4-2018):
Cervival cancer

Cervical cancer:
- Virtually all cervical cancers result from a persistent infection with certain high-
risk types of the HPV-family
- Is one of the strongest, uncovered links between an environmental agent
inducing malignancies in humans.

Cervical cancer is the third most common cancer in woman worldwide.

Cervical cancer is most often a squamous cell carcinoma.

Normal: Cancerous (malignant):
Squamous epithelium Squamous cell carcinoma
Mucinous columnar (kubisch) cells Adenocarcinoma

Cervical cancer arises at the transformation zone!

Endocervix: mucinous columnar  produces mucus, to protect the cervical entrance.
Exocervix: stratified squamous epithelium

Transformation zone:
Meeting point between the two types of epithelia, where cancers arise.  where the
HPV-virus infects the cells.

Simple + stratified epithelium meet each other at this point.

!! During adolescence the transformation zone is more exposed  making
adolescent women more susceptible to HPV-infection.

VERY IMPORTANT SLIDE: Metaplasia – dysplasia – Malignant neoplasia:

, Hormonal changes can change the differentiation of a tumor;

- The abnormal differentiation is called: metaplasia  cells differentiate into a
different type, caused by the hormonal status.
- Metaplastic epithelium can change into dysplastic squamous epithelium 
abnormal differentiation and maturation cells alter their morphology, ‘’a little
mess occurs’’, cytological abnormalities arise. This is caused by the HPV-virus
entering the metaplastic cells.
o These are pre-cursor lesions that can turn into Malignant neoplasia 
squamous cell carcinoma arises.

Normal stage: non-keratinized stratified squamous epithelium
Due to HPV, differentiation is disrupted and cells are beginning to look a little
strange.

*These dysplastic cells can be graded by means of severity:




CIN-lesions = cervical intraepithelial neoplasia lesions

Severe dysplasia is the last stage for occurrence of squamous cell carcinoma.
- The transformation from severe dysplasia  malignant neoplasia can be
induced by the normal cells breaching through the basal membrane.

In situ = ter plaatse

In dysplastic epithelial cells:
Nuclear size expands, cytoplasm decreases, pleiomorphism occurs  a lot of
different shapes and sizes of nuclei.
Anaplasia: when cells look entirely different than the cells in the tissue of origin.

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