Cervical Malignancy

FIG. 3.85. Recurrent cervical carcinoma with vesicovaginal fistula. Fat-suppressed, gadolinium-enhanced T1-weighted image of pelvis demonstrates enhancing infiltrating pelvic tumor (<italic>arrow</bold>) and wide communication between bladder and vagina (<italic>arrowhead</bold>) allowing passage of high signal intensity gadolinium.

<bold>Figure 6.15 Atypical squamous cells of undetermined significance (ASC-US).</bold> This Pap smear shows superficial-type squamous cells with mild nuclear enlargement and hyperchromasia. These features are suggestive but not diagnostic of a low-grade squamous intraepithelial lesion.

<bold>Figure 6.16 Low-grade squamous intraepithelial lesion (Pap smear).</bold> These lesions show mildly dysplastic squamous cells with nuclear enlargement, hyperchromasia, and irregular nuclear contours that are more pronounced than in Figure 6.15.

<bold>Figure 6.17 High-grade squamous intraepithelial lesion (Pap smear).</bold> The dysplastic cells seen in the center show a high nuclear-to-cytoplasmic ratio.

<bold>Figure 6.18 High-grade squamous intraepithelial lesion (Pap smear).</bold> A cluster of overlapping, markedly dysplastic cells forms a sheet. Note single, severely dysplastic cells.

Pap smear 1. Close up view of cross section of upper vagina and cervix with applicator inserted into the endocervical canal. Arrows indicate a clockwise rotation to obtain sample.

Pap smear 2. Close up view of cross section of upper vagina and cervix with wooden or plastic spatula pressed against cervix, longer end introduced slightly into os. Arrow indicates rotation to obtain ectocervical sample.

<bold><italic>Figure 21-12</bold> Pap smears. A:</bold> Normal. Large, flat cells with small nuclei. <bold>B:</bold> Dysplasia. Large, dark nuclei indicate damaged DNA; cytoplasmic halo indicates human papillomavirus (HPV) effect. <bold>C:</bold> Malignant. Compact cells with huge, irregular, dark nuclei indicate malignancy.

<bold><italic>Figure 6-16</bold> Pap smear of the cervix.</bold> Many normal cells are present, which have small, uniform nuclei. Also present are clumps of malignant cells, which have large, dark nuclei.

Normal cervical Papanicolaou (Pap) smear. Large squamous cells from the superficial, and intermediate layers of the epithelium are illustrated. The cells have abundant cytoplasm, which varies in staining from pink to blue. The nuclei are small, and the nuclear-cytoplasmic ratio is low. The most superficial cells have pyknotic nuclei (arrows).