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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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