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Gynecological Cancers: Pathology and Cytological Methods for Diagnosis of Gynecological Cancers

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Abstract

Gynecological cancers represent cancers arising from the female genital tract. The most common cancer in female genital tract is carcinoma cervix. Carcinoma cervix is preceded by precancerous lesions, which can be detected by screening tests such as cervical Pap smear and HPV detection. Endometrial carcinoma is usually detected on endometrial curettings or biopsy, as endometrial aspiration cytology is not reliable. Cervical smear may occasionally represent cells arising from endometrial carcinoma. Majority of ovarian tumors are epithelial tumors, papillary serous carcinoma being the most common. Although FNAC in ovarian neoplasms is not a preferred technique, the same may be performed in young females as initial work-up, in advanced ovarian malignancies, and in the follow-up of patients after chemotherapy or radiotherapy. This chapter includes pathology of gynecological cancers and cytological evaluation of the same such as cervical Pap test for cervical carcinomas and fine needle aspiration cytology mainly for ovarian tumors.

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Abbreviations

AGCT:

Adult granulosa cell tumor

AIS:

Adenocarcinoma in situ

CCC:

Clear cell carcinoma

CEA:

Carcinoembryonic antigen

CIN:

Cervical intraepithelial neoplasia

CIS:

Carcinoma in-situ

CK:

Cytokeratin

ESS:

Endometrial stromal sarcoma

FDA:

Food and drug administration

FNAC:

Fine needle aspiration cytology

H&E:

Hematoxylin and Eosin stain

HPV:

Human papilloma virus

HSIL:

High grade squamous intraepithelial lesions

JGCT:

Juvenile granulosa cell tumor

LBC:

Liquid based cytology

LMS:

Leiomyosarcoma

LSIL:

Low-grade squamous intraepithelial lesions

MGG:

May Grünwald Geimsa stain

MMMT:

Malignant mixed müllerian tumor

Pap:

Papanicolaou stain

PAS:

Periodic acid-Schiff’s stain

PCR:

Polymerase chain reaction

SCC:

Squamous cell carcinoma

SIL:

Squamous intraepithelial lesions

STIC:

Serous tubal intra-epithelial carcinoma

TBS:

The Bethesda System

VIA:

Visual inspection using acetic acid

VILI:

Visual inspection using Lugol’s iodine

References

  1. Ferlay J, Shin H-R, Bray F, Forman D, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.

    Article  PubMed  CAS  Google Scholar 

  2. Arulponni TR, Janaki MG, Nirmala S, Ramesh BS, Rishi KS, Kirthi K. Carcinoma cervix treated with radiotherapy—our experience with emphasis on our concern. J Obstet Gynaecol India. 2010;60:61–5.

    Article  Google Scholar 

  3. Ostor AG. Natural history of cervical intraepithelial neoplasia: a critical review. Int J Gynecol Pathol. 1993;12:186–92.

    Article  PubMed  CAS  Google Scholar 

  4. Holowaty P, Miller AB, Rohan T, et al. Natural history of dysplasia of the uterine cervix. J Natl Cancer Inst. 1999;91:252.

    Article  PubMed  CAS  Google Scholar 

  5. Colgan TJ, Lickrish GM. The topography and invasive potential of cervical adenocarcinoma in situ, with and without associated squamous dysplasia. Gynecol Oncol. 1990;36:246–9.

    Article  PubMed  CAS  Google Scholar 

  6. Denehy TR, Gregori CA, Breen JL. Endocervical curettage, cane margins, and residual adenocarcinoma in situ of the cervix. Obstet Gynecol. 1997;90:1–6.

    Article  PubMed  CAS  Google Scholar 

  7. Ursin G, Pike MC, Preston-Martin S, et al. Sexual, reproductive, and other risk factors for adenocarcinoma of the cervix, results from a population based case– control study. Cancer Causes Control. 1996;7:391–401.

    Article  PubMed  CAS  Google Scholar 

  8. Gupta N, Srinivasan R, Rajwanshi A. Functional biomarkers in cervical precancer: an overview. Diagn Cytopathol. 2010;38:618–23.

    PubMed  Google Scholar 

  9. Gupta N, Desai M. New technologies in cervical cancer screening. BIDA AGM. 2011;18:5–6.

    Google Scholar 

  10. Ridder R, Luyten A, Scherbring S, Reinecke-Luettge A, Schmidt D, Petry KU. Triaging PAP negative, HPV positive cervical cancer screening test results by p16/Ki67 dual stained cytology. Acta Cytol. 2010;54(3):404–5.

    Google Scholar 

  11. National Institute for Clinical Excellence (NICE). NHS Technology Appraisal Guidance 69. Guidance on the use of liquid-based cytology (LBC) for cervical screening. London: National Institute for Clinical Excellence; 2003.

    Google Scholar 

  12. Utagawa ML, Pereira SM, Makabe S, et al. Pap test in a high risk population comparison of conventional and liquid-based cytology. Diagn Cytopathol. 2004;31:169–72.

    Article  PubMed  Google Scholar 

  13. Strander B, Andersson-Ellstrom A, Milsom I, et al. Liquid-based cytology versus conventional papanicolaou smear in an organized screening program. Cancer Cytopathol. 2007;111:285–91.

    Google Scholar 

  14. Schledermann D, Ejersbo D, Hoelund B. Improvement of diagnostic accuracy and screening conditions with liquid-based cytology. Diagn Cytopathol. 2006;34:780–5.

    Article  PubMed  Google Scholar 

  15. Confortini M, Bergeron C, Desai M, et al. Accuracy of liquid-based cytology. Cancer. 2010;118:203–8.

    Google Scholar 

  16. Siebers AG, Klinkhamer PJJM, Grefte JMM, et al. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors. JAMA. 2009;302:1757–64.

    Article  PubMed  CAS  Google Scholar 

  17. Farthing A, Masterson P, Mason WP, Vousden KH. Human papillomavirus detection by hybrid capture & it’s possible clinical use. J Clin Pathol. 1994;47:649–52.

    Article  PubMed  CAS  Google Scholar 

  18. Ergünay K. Detection and typing of human Papilloma virus by polymerase chain reaction and hybridization assay in cervical samples with cytological abnormalities. Mikrobiyol Bull. 2008;42:273–82.

    Google Scholar 

  19. Hubbard RA. Human papillomavirus testing methods. Arch Pathol Lab Med. 2003;127:940–5.

    PubMed  CAS  Google Scholar 

  20. Gupta N, Dudding N, Smith JHF. Cytomorphological features of extra-genital metastases in SurePath™ cervical liquid-based cytology: a series of eight cases. Cytopathology 2012; doi: 10.1111/j.1365-2303.2011.00945.x.

    Google Scholar 

  21. Liu FS. Molecular carcinogenesis of endometrial cancer. Taiwan J Obstet Gynecol. 2007;46:26–32.

    Article  PubMed  CAS  Google Scholar 

  22. Sherman ME, Bur ME, Kurman RJ. p53 in endometrial cancer and its putative precursors: Evidence for diverse pathways of tumorigenesis. Hum Pathol. 1995;26:1268–74.

    Article  PubMed  CAS  Google Scholar 

  23. Mutter GL. PTEN, a protean tumor suppressor. Am J Pathol. 2001;158:1895–8.

    Article  PubMed  CAS  Google Scholar 

  24. Matias-Guiu X, Catasus L, Bussaglia E, et al. Molecular pathology of endometrial hyperplasia and carcinoma. Hum Pathol. 2001;32:569–77.

    Article  PubMed  CAS  Google Scholar 

  25. Cherkis RC, Patten Jr SF, Andrews TJ, Dickinson JC, Patten FW. Significance of normal endometrial cells detected by cervical cytology. Obstet Gynecol. 1988;71:242–4.

    PubMed  CAS  Google Scholar 

  26. DuBeshter B, Warshol DP, Angel C, Dvoretsky PM, Lin JY, Raubertas RF. Endometrial carcinoma: the relevance of cervical cytology. Obstet Gynecol. 1991;77:458–62.

    PubMed  CAS  Google Scholar 

  27. Ronneett BM, Zaino RJ, Ellenson LH, Kurman RJ. Endometrial carcinoma. In: Kurman RJ, editor. Blaustein’s pathology of the female genital tract. 5th ed. New Delhi: Springer; 2004. p. 501–59.

    Google Scholar 

  28. Gupta N, Awasthi A, Rajwanshi A, Malhotra S. Fine needle aspiration cytology of low grade endometrial stromal sarcoma—a case report. Acta Cytol. 2007;51(3):461–3.

    Article  PubMed  Google Scholar 

  29. Scully RE, Bonfiglio TA, Kurman RJ, Silverberg SG, Wilkinson EJ. World Health Organization international histological classification of tumors: histological typing of female genital tract tumors. 2nd ed. Berlin: Springer; 1994.

    Book  Google Scholar 

  30. Auersperg N. Origin of ovarian carcinomas: a unifying hypothesis. Int J Gynaecol Pathol. 2010;30:12–21.

    Article  Google Scholar 

  31. Murthy NS, Shalini S, Suman G. Changing trends in incidence of ovarian cancer—the Indian scenario. Asian Pac J Cancer Prev. 2009;10:1025–30.

    PubMed  Google Scholar 

  32. Layfield LJ, Berek JS. Fine-needle aspiration cytology in the management of gynecologic oncology patients. Cancer Treat Res. 1994;70:1–13.

    Article  PubMed  CAS  Google Scholar 

  33. Kurman RJ, Shih leM. The origin and pathogenesis of epithelial ovarian cancer—a proposed unifying theory. Am J Surg Pathol. 2010;34:433–43.

    Google Scholar 

  34. Partridge EE, Phillips JL, Menck HR. The National Cancer Data Base report on ovarian cancer treatment in United States hospitals. Cancer. 1996;78:2236–46.

    Article  PubMed  CAS  Google Scholar 

  35. Komiyama S, Aoki D, Tominaga E, Susumu N, Udagawa Y, Nozawa S. Prognosis of Japanese patients with ovarian clear cell carcinoma associated with pelvic endometriosis: clinicopathologic evaluation. Gynecol Oncol. 1999;72:342–6.

    Article  PubMed  CAS  Google Scholar 

  36. Yoshikawa H, Jimbo H, Okada S, Matsumoto K, Onda T, Yasugi T, Taketani Y. Prevalence of endometriosis in ovarian cancer. Gynecol Obstet Invest. 2000;50:11–7.

    Article  PubMed  Google Scholar 

  37. Ramalingam P, Malpica A, Silva EG, Gershenson DM, Liu JL, Deavers MT. The use of cytokeratin 7 and EMA in differentiating ovarian yolk sac tumors from endometrioid and clear cell carcinomas. Am J Surg Pathol. 2004;28:1499–505.

    Article  PubMed  Google Scholar 

  38. Dharan M. Intra-operative cytology of small cell carcinoma of the ovary with hypercalcemia: a case report. Acta Cytol. 1993;37:61–6.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Nalini Gupta & Arvind Rajwanshi

Authors
  1. Nalini Gupta
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  2. Arvind Rajwanshi
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Correspondence to Arvind Rajwanshi .

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Editors and Affiliations

  1. Baylor College of Medicine, Baylor Plaza 1, Houston, 77030, Texas, USA

    Mahesh K. Shetty

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Gupta, N., Rajwanshi, A. (2013). Gynecological Cancers: Pathology and Cytological Methods for Diagnosis of Gynecological Cancers. In: Shetty, M. (eds) Breast and Gynecological Cancers. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1876-4_3

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  • DOI: https://doi.org/10.1007/978-1-4614-1876-4_3

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