Jan 2003, ASCUS

July 2003, ASCUS

Nov 2003

• HPV • CIN I

Jan 2004, LGSIL

Jun 2004, HGSIL

Sept 2004, LEEP

HPV CIN

Sept 2004

CIN

Sept 2004

CIN III

Sept 2004

• Small, rounded, oval nests of tumor cells

• Haphazard arrangement

• Deep to EN glands

• Microcyst

formation • No

desmoplasia • No

inflammation

• Peripheral palisading

• Basaloid cells

• Acini formation

• Basaloid cells

• Peripheral palisading

• Squamous differentiation

• Squamous differentiation

• Infrequent mitotic activity

• No atypical forms

Adenoid basal carcinoma

• Peripheral palisades of basaloid cells

• Central squamous differentiation

• Microcyst formation

• No desmoplastic reaction

Diagnosis

• CIN III, margin involved • HPV infection • Adenoid basal carcinoma

Adenoid basal carcinoma

• Uncommon • Typical clinical scenario • Elderly • Incidental finding • Associate with overlying CIN • Confined to the cervix

Differential diagnoses • Pseudoepitheliomatous

hyperplasia • Inflammation

• Squamous metaplasia • Superficial

• Adenoid cystic carcinoma • Widely infiltrative, cribriform, basement membrane material, no squamous nests

• SCC with basaloid features • Malignant squamous cytology