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The incidence of cervical adenocarcinoma, in contrast, has increased significantly, with a reported 22.5% increase in age-adjusted incidence between 19.In addition to squamous and glandular neoplasms, neuroendocrine, mesenchymal, and metastatic tumors can also involve the cervix.Damage and denudation of the mucosa occur readily even with minor trauma to the cervix.Poor orientation with tangential sections not only precludes accurate interpretation of lesion grade or invasive extent, but also contributes to erroneous diagnoses.Prolonged contact between the loop and the tissue results in broad zones of thermal damage, coagulative necrosis, and tissue distortion that preclude an accurate diagnosis of the lesion and the status of excision margins.In one study, 20% of ectocervical margins and 44% of endocervical margins removed by LEEP were unsatisfactory for evaluation.The status of excision margins correlates well with the subsequent recurrence of SIL/CIN.Cervical conization by cold knife is most often performed for extensive HSIL and for HSIL with suspected coexisting invasive carcinoma.
The emphasis is on proper handling and reporting of surgical specimens, pathologic classification and criteria, and important pathologic parameters, all of which have an impact on the prognosis and management of the patient.
After the blood and mucus at the base of the tissue become adherent to the paper towel, the specimen and the paper towel are placed in buffered formalin and submitted to the laboratory accompanied by adequate demographic and clinical information.
The single most common cause of an inadequate biopsy specimen is the failure to provide abnormal tissue of sufficient amount and depth.
Finally, recent updates in screening and prevention are discussed.
The accuracy of histologic interpretation and diagnosis is strongly governed by the quality of tissue provided, as well as proper handling and processing of the specimen.