Cervical dysplasia pathophysiology

Cervical dysplasia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix that are seen underneath a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Although these changes are not cancer, they can lead to cancer of the cervix if not treated.

Pathogenesis of cervical cancer

• Human papillomaviruses subtypes 16 and 18 (High risk) play an essential role in the pathogenesis of cervical cancer. Once HPV enters an epithelial cell, the virus begins to make the proteins it encodes. Two of the proteins made by high-risk HPVs (E6 and E7) interfere with cell functions that normally prevent excessive growth, helping the cell to grow in an uncontrolled manner and to avoid cell death. Many times these infected cells are recognized by the immune system and eliminated. Sometimes, however, these infected cells are not destroyed, and a persistent infection results. As the persistently infected cells continue to grow, they may develop mutations in cellular genes that promote even more abnormal cell growth, leading to the formation of an area of precancerous cells.
• Cervical dysplasia has its origins at the squamous-columnar junction; it can involve the outer squamous cells, the inner glandular cells, or both. The precursor lesion is dysplasia: cervical intraepithelial neoplasia (CIN) or adenocarcinoma in situ.

Video

Below is a video of pap smear showing low grade cervical dysplasia (CIN 1)

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Below is a video showing high grade cervical dysplasia (Gross,Cytology,Histology)

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