INTRODUCTION
Carcinoma-in-situ of Cervix usually progresses as infiltrating carcinoma involving vagina, uterus or pelvic and peripelvic tissue. Very rarely, carcinoma-in-situ can extend into the uterine cavity spreading along the endometrium into both fallopian tubes. The morphology remains as in-situ and the neoplastic squamous epithelial cells replace endometrial tissue and mucosa of the fallopian tube.
CASE HISTORY
A female patient of age 60 years presented with occasional bleeding per vagina. Clinical findings showed postmenopausal changes like atrophic uterus, otherwise unremarkable.
PATHOLOGICAL FINDINGS
Gross
- Uterus with both fallopian tubes and ovaries, measuring 6cm×3cm×2cm.
- Cut section showed slight thickening of ectocervix, endocervical canal and endometrium.
- Both fallopian tubes showed thickened wall.
- Ovaries were atrophic and small.
Microscopic findings
- Section from cervix showed uniform thickened epithelium with severe dysplasia/carcinoma-in-situ changes (Figure 1). The epithelial changes were limited to epithelium only and there was no evidence of infiltration into the stroma (Figure 2 and 3).
- Sections from endocervical canal (Figure 4), endometrium (Figure 5 and 6) and fallopian tubes (Figure 7 and 8) showed replacement of respective covering epithelium by dysplastic squamous epithelium. There was no evidence of invasion in any of these tissues.
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Figure 1 4X) |
Figure 2 (10X) |
Figure 3 (40X) |
Figure 4 (4X) |
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Figure 5 (4X) |
Figure 6 (10X) |
Figure 7 (4X) |
Figure 8 (4X) |
HISTOLOGICAL DIAGNOSIS
Carcinoma-in-situ Cervix with extension into Endometrium and both Fallopian tubes as in-situ.