Endocervical adenocarcinoma in situ - Revision history

Mitchell: /* Microscopic */ Put in ioffe scoring system

2017-02-14T18:38:16Z

Microscopic: Put in ioffe scoring system

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	#*Normal gland spacing - lack of complexity ("lobular pattern").		#*Normal gland spacing - lack of complexity ("lobular pattern").
	#*Normal gland depth (subjective).		#*Normal gland depth (subjective).

			Ioffe, et al, :<ref name=pmid12657929>{{cite journal \|author=Ioffe OB, Sagae S, Moritani S, Dahmoush L, Chen TT, Silverberg SG. \|title=Proposal of a new scoring scheme for the diagnosis of noninvasive endocervical glandular lesions \|journal=Am J Surg Pathol \| volume=27 \| issue=4\| pages=452–460 \| year=2003 \| pmid=12657929 \|pmc= \|doi= \|url= }}</ref> devised a reproducible schema by which one might discern reactive glandular atypia, glandular dysplasia, and adenocarcinoma in situ, summarized in the table below from the article:

			Sum the scores for stratification, nuclear atypia, and mitoses/apoptotic bodies<br>
			<br>
			Stratification<br>
			None (0 points)<br>
			Mild (1 point)<br>
			Moderate (2 points)<br>
			Up to the luminal surface (3 points)<br>
			<br>
			Nuclear atypia<br>
			As normal (0 points)<br>
			Small (size of normal) or slightly enlarged uniform nuclei, minimal hyperchromasia, little dispolarity, no nucleoli (1 point)<br>
			Nuclear enlargement (≤3× normal), moderate anisocytosis/hyperchromasia/dispolarity, occasional small nucleoli (2 points)<br>
			Large nuclei (>3× normal), marked anisocytosis, marked hyperchromasia, severe dispolarity, frequent prominent nucleoli (3 points)<br>
			<br>
			Mitoses and apoptoses in two most active glands, number per gland (average between two glands)<br>
			None (0 points)<br>
			Less than 0.5 per gland (1 point)<br>
			0.6–3.0 per gland (2 points)<br>
			>3.0 per gland (3 points)<br>
			<br>
			Total score 0–3 = benign 4–5 = endocervical glandular dysplasia (EGD) 6–9 = adenocarcinoma in situ


	DDx:		DDx:

Michael: /* Images */

2016-06-05T14:52:12Z

Images

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	===Images===		===Images===
			====Case - ECC====
	<gallery>		<gallery>
	Image: Endocervical adenocarcinoma in situ -- intermed mag.jpg \| AIS - intermed. mag.		Image: Endocervical adenocarcinoma in situ -- intermed mag.jpg \| AIS - intermed. mag.
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	Image: Endocervical adenocarcinoma in situ 2a -- very high mag.jpg \| AIS - very high mag.		Image: Endocervical adenocarcinoma in situ 2a -- very high mag.jpg \| AIS - very high mag.
	Image: Endocervical adenocarcinoma in situ 2b -- very high mag.jpg \| AIS - very high mag.		Image: Endocervical adenocarcinoma in situ 2b -- very high mag.jpg \| AIS - very high mag.
			</gallery>
			====Case - biopsy====
			<gallery>
			Image: Endocervical adenocarcinoma in situ --- intermed mag.jpg \| AIS - intermed. mag.
			Image: Endocervical adenocarcinoma in situ --- high mag.jpg \| AIS - high mag.
			Image: Endocervical adenocarcinoma in situ --- very high mag.jpg \| AIS - very high mag.

			Image: Endocervical adenocarcinoma in situ - alt --- intermed mag.jpg \| AIS - intermed. mag.
			Image: Endocervical adenocarcinoma in situ - alt --- high mag.jpg \| AIS - high mag.
			Image: Endocervical adenocarcinoma in situ - alt --- very high mag.jpg \| AIS - very high mag.

			Image: Endocervical adenocarcinoma in situ - p16 --- intermed mag.jpg \| AIS - p16 - intermed. mag.
			Image: Endocervical adenocarcinoma in situ - p16 --- high mag.jpg \| AIS - p16 - high mag.
			Image: Endocervical adenocarcinoma in situ - p16 --- very high mag.jpg \| AIS - p16 - very high mag.

			Image: Endocervical adenocarcinoma in situ - ki67 --- intermed mag.jpg \| AIS - Ki-67 - intermed. mag.
			Image: Endocervical adenocarcinoma in situ - ki67 --- high mag.jpg \| AIS - Ki-67 - high mag.
			Image: Endocervical adenocarcinoma in situ - ki67 --- very high mag.jpg \| AIS - Ki-67 - very high mag.
	</gallery>		</gallery>
	====www====		====www====

Michael: /* Images */ fix

2015-08-18T02:35:07Z

Images: fix

← Older revision		Revision as of 02:35, 18 August 2015
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	Image: Endocervical adenocarcinoma in situ 2b -- very high mag.jpg \| AIS - very high mag.		Image: Endocervical adenocarcinoma in situ 2b -- very high mag.jpg \| AIS - very high mag.
	</gallery>		</gallery>
	www:		====www====
	*[~~http~~://www.~~flickriver~~.com/photos/euthman/~~tags/cervix/~~ Endocervical AIS adjacent to normal (~~flickriver~~.com/euthman)].		*[https://www.flickr.com/photos/euthman/1799754415 Endocervical AIS adjacent to normal (flickr.com/euthman)].
	*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)].		*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)].
	*[http://womenshealthsection.com/content/gynpc/gynpc006d.jpg Endocervical adenocarcinoma in situ (womenshealthsection.com)].<ref>URL: [http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english]. Accessed on: 20 March 2013.</ref>		*[http://womenshealthsection.com/content/gynpc/gynpc006d.jpg Endocervical adenocarcinoma in situ (womenshealthsection.com)].<ref>URL: [http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english]. Accessed on: 20 March 2013.</ref>

Michael: /* IHC */ +SO

2014-05-02T17:55:02Z

IHC: +SO

← Older revision		Revision as of 17:55, 2 May 2014
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	*CEA +ve.		*CEA +ve.
	*Vimentin -ve.		*Vimentin -ve.

			==Sign out==
			<pre>
			UTERINE CERVIX, BIOPSY:
			- HIGH-GRADE SQUAMOUS INTRAEPITHELIAL LESION (HSIL).
			- ENDOCERVICAL ADENOCARCINOMA IN SITU (AIS).
			- ACUTE AND CHRONIC INFLAMMATION.

			COMMENT:
			A p16 immunostain marks the full thickness of the squamous epithelium and is
			strong. A Ki-67 immunostain marks increased numbers of superficial squamous cells.

			The atypical endocervical epithelium (interpreted as AIS) is strongly p16 positive
			and has an increased proliferative activity with Ki-67 staining.
			</pre>

			===Micro===
			The atypical endocervical epithelium (interpreted as AIS) shows marked hyperchromasia, nuclear crowding and moderate nuclear atypia with a relatively abundant cytoplasm ( nucleus to cell size = 1:2 ).

	==See also==		==See also==

Michael at 02:20, 25 April 2014

2014-04-25T02:20:52Z

← Older revision		Revision as of 02:20, 25 April 2014
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	\| Caption = Endocervical adenocarcinoma in situ. [[H&E stain]].		\| Caption = Endocervical adenocarcinoma in situ. [[H&E stain]].
	\| Synonyms =		\| Synonyms =
	\| Micro =		\| Micro = Nuclear changes (nuclear crowding/pseudostratification, nuclear enlargement (often cigar-shaped nuclei), coarse chromatin, small nucleolus or nucleoli), +/-mitoses, +/-reduced cytoplasmic mucin, preservation of glandular architecture
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[Tubal metaplasia of the uterine cervix\|tubal metaplasia]], [[Arias-Stella reaction]], [[endometriosis]], lower uterine segment epithelium (esp. [[proliferative phase endometrium]]), [[endocervical adenocarcinoma]], [[metastasis\|metastatic]] adenocarcinoma		\| LMDDx = [[Tubal metaplasia of the uterine cervix\|tubal metaplasia]], [[Arias-Stella reaction]], [[endometriosis]], lower uterine segment epithelium (esp. [[proliferative phase endometrium]]), [[endocervical adenocarcinoma]], [[metastasis\|metastatic]] adenocarcinoma
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	\| Assdx = squamous lesions ([[LSIL]], [[HSIL]])		\| Assdx = squamous lesions ([[LSIL]], [[HSIL]])
	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =		\| Clinicalhx = +/-[[HPV]]
	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms = asymptomatic
	\| Prevalence = uncommon		\| Prevalence = uncommon
	\| Bloodwork =		\| Bloodwork =
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	\| Prognosis =		\| Prognosis =
	\| Other =		\| Other =
	\| ClinDDx = [[endometrial carcinoma]]		\| ClinDDx = [[endocervical adenocarcinoma]] (invasive), [[endometrial carcinoma]], squamous cervical lesions
	\| Tx = typically [[LEEP]]		\| Tx = typically [[LEEP]]
	}}		}}

Michael at 02:16, 25 April 2014

2014-04-25T02:16:30Z

← Older revision		Revision as of 02:16, 25 April 2014
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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image = Endocervical adenocarcinoma in situ -- high mag.jpg		\| Image = Endocervical adenocarcinoma in situ -- very high mag.jpg
	\| Width =		\| Width =
	\| Caption = Endocervical adenocarcinoma in situ. [[H&E stain]].		\| Caption = Endocervical adenocarcinoma in situ. [[H&E stain]].

Michael: /* Images */

2014-04-25T02:16:13Z

Images

← Older revision		Revision as of 02:16, 25 April 2014
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	===Images===		===Images===
			<gallery>
			Image: Endocervical adenocarcinoma in situ -- intermed mag.jpg \| AIS - intermed. mag.
			Image: Endocervical adenocarcinoma in situ -- high mag.jpg \| AIS - high mag.
			Image: Endocervical adenocarcinoma in situ -- very high mag.jpg \| AIS - very high mag.
			Image: Endocervical adenocarcinoma in situ 2 -- intermed mag.jpg \| AIS - intermed. mag.
			Image: Endocervical adenocarcinoma in situ 2 -- high mag.jpg \| AIS - high mag.
			Image: Endocervical adenocarcinoma in situ 2a -- very high mag.jpg \| AIS - very high mag.
			Image: Endocervical adenocarcinoma in situ 2b -- very high mag.jpg \| AIS - very high mag.
			</gallery>
			www:
	*[http://www.flickriver.com/photos/euthman/tags/cervix/ Endocervical AIS adjacent to normal (flickriver.com/euthman)].		*[http://www.flickriver.com/photos/euthman/tags/cervix/ Endocervical AIS adjacent to normal (flickriver.com/euthman)].
	*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)].		*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)].

Michael: +infobox

2014-04-25T01:16:25Z

+infobox

← Older revision		Revision as of 01:16, 25 April 2014
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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Endocervical adenocarcinoma in situ -- high mag.jpg
			\| Width =
			\| Caption = Endocervical adenocarcinoma in situ. [[H&E stain]].
			\| Synonyms =
			\| Micro =
			\| Subtypes =
			\| LMDDx = [[Tubal metaplasia of the uterine cervix\|tubal metaplasia]], [[Arias-Stella reaction]], [[endometriosis]], lower uterine segment epithelium (esp. [[proliferative phase endometrium]]), [[endocervical adenocarcinoma]], [[metastasis\|metastatic]] adenocarcinoma
			\| Stains =
			\| IHC = p16 +ve
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[uterine cervix]] - endocervical canal
			\| Assdx = squamous lesions ([[LSIL]], [[HSIL]])
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence = uncommon
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis =
			\| Other =
			\| ClinDDx = [[endometrial carcinoma]]
			\| Tx = typically [[LEEP]]
			}}
	:''For the cytology see [[Gynecologic cytopathology#Endocervical adenocarcinoma in situ\|Endocervical adenocarcinoma in situ (cytology)]]''		:''For the cytology see [[Gynecologic cytopathology#Endocervical adenocarcinoma in situ\|Endocervical adenocarcinoma in situ (cytology)]]''
	'''Endocervical adenocarcinoma in situ''', also '''adenocarcinoma in situ of the uterine endocervix''', is pre-invasive change of the [[uterine cervix\|uterine endocervix]]. It is closely tied to [[HPV]] infection.		'''Endocervical adenocarcinoma in situ''', also '''adenocarcinoma in situ of the uterine endocervix''', is pre-invasive change of the [[uterine cervix\|uterine endocervix]]. It is closely tied to [[HPV]] infection.

Michael: split out

2014-04-25T00:56:56Z

split out

← Older revision		Revision as of 00:56, 25 April 2014
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	#~~redirect~~ [[~~Uterine_cervix~~#~~Endocervical_adenocarcinoma_in_situ~~]]		:''For the cytology see [[Gynecologic cytopathology#Endocervical adenocarcinoma in situ\|Endocervical adenocarcinoma in situ (cytology)]]''
			'''Endocervical adenocarcinoma in situ''', also '''adenocarcinoma in situ of the uterine endocervix''', is pre-invasive change of the [[uterine cervix\|uterine endocervix]]. It is closely tied to [[HPV]] infection.

			If the context is clear, it may be referred to as '''[[adenocarcinoma in situ]]''', abbreviated '''AIS'''.

			==General==
			*Usually due to [[HPV]].
			*May be found together with squamous neoplasias of the cervix.
			*AIS of the cervix is much less common than squamous dysplasia of the cervix/SCC of the cervix.
			*Generally, definitely diagnosed with an ''endocervical curettage'' (ECC).

			==Gross==
			*Not apparent at colposcopy.

			==Microscopic==
			Features:<ref name=pmid10757337>{{Cite journal \| last1 = Zaino \| first1 = RJ. \| title = Glandular lesions of the uterine cervix. \| journal = Mod Pathol \| volume = 13 \| issue = 3 \| pages = 261-74 \| month = Mar \| year = 2000 \| doi = 10.1038/modpathol.3880047 \| PMID = 10757337 \| url = http://www.nature.com/modpathol/journal/v13/n3/full/3880047a.html }}</ref>
			#Nuclear changes - '''key feature''':
			#*Variable nuclear stratification.
			#**Nuclear crowding/pseudostratification.
			#*Nuclear enlargement.
			#**Often cigar-shaped nuclei.
			#*Coarse chromatin.
			#*Small nucleolus or [[nucleoli]].
			#+/-Mitoses.
			#+/-Reduced cytoplasmic mucin.
			#Preservation of glandular architecture.
			#*Normal gland spacing - lack of complexity ("lobular pattern").
			#*Normal gland depth (subjective).

			DDx:
			*[[Tubal metaplasia of the uterine cervix\|Tubal metaplasia]].
			*[[Arias-Stella reaction]].
			*[[Endometriosis]].
			*Lower uterine segment epithelium<ref name=Ref_GP167>{{Ref GP\|167}}</ref> - esp. [[proliferative phase endometrium]] - mitoses rare, NC ratio normal, stroma different.
			*[[Endocervical adenocarcinoma]] - often has paradoxical maturation... paler cytoplasm & nuclei than adjacent AIS.
			*[[metastasis\|Metastatic]] adenocarcinoma.
			*[[Proliferative phase endometrium]] - endometrial type stroma, cytoplasm not pale staining, no nuclear atypia (smooth nuclear contour, stratified).

			===Images===
			*[http://www.flickriver.com/photos/euthman/tags/cervix/ Endocervical AIS adjacent to normal (flickriver.com/euthman)].
			*[http://nih.techriver.net/view.php?patientId=99 Endocervical adenocarcinoma in situ (techriver.net)].
			*[http://womenshealthsection.com/content/gynpc/gynpc006d.jpg Endocervical adenocarcinoma in situ (womenshealthsection.com)].<ref>URL: [http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english http://www.womenshealthsection.com/content/print.php3?title=gynpc006&cat=60&lng=english]. Accessed on: 20 March 2013.</ref>
			*[http://nih.techriver.net/view.php?patientId=67 Endocervical adenocarcinoma in situ - cytology (techriver.net)].

			==IHC==
			*p16 +ve.
			*CEA +ve.
			*Vimentin -ve.

			==See also==
			*[[Endocervical adenocarcinoma]].
			*[[Uterine cervix]].

			==References==
			{{Reflist\|2}}

	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Uterine cervix]]

Michael: redirect to the histology article

2012-05-25T00:44:08Z

redirect to the histology article

← Older revision		Revision as of 00:44, 25 May 2012
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	#redirect [[~~Gynecologic_cytopathology~~#Endocervical_adenocarcinoma_in_situ]]		#redirect [[Uterine_cervix#Endocervical_adenocarcinoma_in_situ]]

	[[Category:Diagnosis]]		[[Category:Diagnosis]]