Histopathological challenges in assessing invasion in squamous, glandular neoplasia of the cervix

Cervical carcinomas usually arise from dysplastic epithelium. Squamous cell carcinoma, the most common type, evolves from cervical intraepithelial neoplasia (CIN) while adenocarcinoma develops from cervical glandular intraepithelial neoplasia (CGIN). The diagnosis of frankly invasive disease does not create a diagnostic problem. In contrast, confident diagnosis of the earliest stage of invasive disease arising from a dysplastic precursor lesion is problematic. The diagnostic process is further complicated by a lack of concordance concerning the nature (and behaviour) of certain diseases associated with the cervix e.g. CIN3-like squamous carcinoma, papillary squamo-transitional cell carcinoma, minimal deviation adenocarcinoma, adenoid basal carcinoma and microcystic adenocarcinoma. In this mini-symposium, an attempt has been made to clarify the features that are suggestive of definitive stromal invasion and to highlight the features of those unusual carcinomas that are often misinterpreted as non-invasive disease.