Benign and malignant pathology of the cervix, including screening

This review focuses on the newly described and redefined benign and malignant lesions of the uterine cervix. The World Health Organization (WHO) classification of the cervix and the Bethesda system are discussed. In addition, the definition of early invasive squamous cell carcinoma is reviewed, and the diagnostic approach, natural history, and oncogenesis of pre-invasive and invasive squamous and glandular lesions are re-examined. The use of human papillomavirus (HPV) DNA detection and its association with cervical intraepithelial neoplasia (CIN) is briefly mentioned. Certain types of benign cervical lesions which mimic neoplasms, including atypical microglandular hyperplasia, and immature papillary metaplasia are mentioned. The unusual subtypes of cervical neoplasm, including villoglandular adenocarcinoma, small cell undifferentiated carcinoma, adenoid basal cell carcinoma, and adenoid cystic carcinoma are reviewed, with emphasis on differential histologic features, as the prognosis for those tumors may differ. Finally, immunohistochemical findings and tumor markers of cervical tumors are briefly mentioned.