Cervix - Cytology
Squamous cell carcinoma of cervix

Author: Ashwyna Sunassee, M.D. (see Authors page)
Editor: Ryan Askeland, M.D.

Revised: 11 May 2017, last major update July 2015

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Squamous cell carcinoma [title] cervix
Cite this page: Squamous cell carcinoma of cervix . PathologyOutlines.com website. http://pathologyoutlines.com/topic/cervixcytologyscc.html. Accessed October 23rd, 2017.
Definition / general
  • Invasive squamous cell carcinoma is the most common malignant neoplasm of the uterine cervix
  • Reduced prevalence due to Papanicolaou smear testing to detect premalignant lesions (currently 1 million cases of SIL detected per year in US, 13,000 new invasive carcinomas)
Case reports
Cytology description
  • Highly irregular shaped cells (tadpole, caudate)
  • Keratinized cells are orange often with squamous pearls
  • Nonkeratinized cells have dense, hard, basophilic cytoplasm
  • Also cannibalism (tumor cells surround other cells)
  • Prominent nucleoli may be seen
  • Compared to adenocarcinoma, have more irregular cellular and nuclear shapes, more cytoplasmic density, more chromatin granularity, more hyperchromasia
  • Tumor diathesis in background (necrosis, hemorrhage, inflammatory cells) is suggestive of malignancy
  • Tumor diathesis in liquid based cytology is more subtle than with with conventional smears
    • Consists of necrotic material at peripheral of cell groups ("clinging diathesis") and not in the background
  • Other features in liquid based cytology are mild to moderate inflammation, coexistent dysplasia, keratinization, decreased cell coverage (Diagn Cytopathol 2002;26:1)
  • Papillary squamotransitional carcinoma of cervix:
    • Liquid based cytology specimens are moderately to highly cellular with three dimensional, arborizing, papillary clusters of basal or parabasal cells
    • Occasional fibrovascular cores
    • Cells vary from bland to SIL
    • Frequent mitotic figures
    • Occasional tumor diathesis and dyskeratotic cells
    • No koilocytosis (Acta Cytol 2003;47:141)
Cytology images

Images hosted on PathOut server:
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Hyperchromatic spindle-like cells with heavy keratinized cytoplasm, SurePath. Images contributed by Frank Melgoza MD and Mai Gu M.D., Ph.D., UC Irvine, California

Images hosted on other servers:
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Invasive SCC

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Keratinizing and nonkeratinizing tumors

Differential diagnosis