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Cervical Histology

by Carlo Raj, MD
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    00:02 We'll now take a look at the cervical histology.

    00:04 So if I told you that the surface of the cervix, the exocervix, was squamous.

    00:10 Take a look at the picture here, and I want you to identify exactly that.

    00:15 We have our transformation zone, please notice the squamous cells.

    00:21 The squamous cells, if you were to then take a look at it in actual histology, in real life histology, you’d expect it to be flat.

    00:31 And then I want you to go further deep into the cervix.

    00:36 What are you entering now? The endocervix.

    00:39 Now, close your eyes.

    00:41 If it’s the endocervix, are you not getting closer to the uterus? Yes, you are.

    00:47 And the uterus, physiologically, is the potential home for a fetus.

    00:54 So therefore, it would make no sense for the uterus to be lined by squamous cells.

    01:01 I want you to move over to the left now of your squamous cell.

    01:05 As you move to the left, you’re getting deeper into the cervix, and you’re moving towards the uterus.

    01:13 Have you now established orientation of where you are in the pelvic region? If you’re moving deeper into the cervix and into the uterus perhaps, then these cells that are lining this cavity or this area would be columnar.

    01:30 And therefore, as you officially then move into the uterus, it would be your complete columnar or glandular cells.

    01:37 Now, Now, you see the cartoon for columnar cells.

    01:42 Underneath it, you’ll see real life histology of your columnar cells.

    01:47 And these are much more finger-like or glandular.

    01:50 You’ll notice that.

    01:52 I want you to be crystal clear about the histologic differences between the exocervix squamous and the endocervix columnar.

    02:01 Why? Because of the following.

    02:05 Let’s say that you have a patient who has an HPV infection and it’s the high-risk strain.

    02:12 This transformation zone, collectively, is where HPV loves to live in the transformation zone.

    02:23 So now, the high-risk strain of HPV, if it is to then contribute, or perhaps, develop cervical cancer, which one of these cell types does it choose 85% of the time? Squamous cell cancer.

    02:38 Good.

    02:39 Why? I don’t know.

    02:41 But it does clinically. That’s what’s important.

    02:46 So is there a possibility that HPV high-risk strain might then give rise to adenocarcinoma? Absolutely.

    02:51 However, 85% of the time, it would be squamous.

    02:55 Spend a few minutes.

    02:56 Make sure that your focus should be the transformation zone, especially between the right side squamous exocervix, the left side endocervix with columnar cells.

    03:08 And please be able to identify their real life histologic picture.


    About the Lecture

    The lecture Cervical Histology by Carlo Raj, MD is from the course Disorders of Vulva, Vagina and Cervix.


    Included Quiz Questions

    1. ...transformation zone.
    2. ...smooth muscles of the cervical canal.
    3. ...squamous epithelium in ectocervix.
    4. ...glandular epithelium in endocervix.
    5. ...Nabothian cyst.
    1. ... squamous epithelium transitioning into columnar epithelium.
    2. ...columnar epithelium transitioning into squamous epithelium.
    3. ...gradual increase in number of blood vessels from exocervix to endocervix.
    4. ...gradual increase in muscularity from exocervix to endocervix.
    5. ...gradual increase in secretions from exocervix to endocervix.

    Author of lecture Cervical Histology

     Carlo Raj, MD

    Carlo Raj, MD


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