— endocervical: 70% of cervical adenocarcinomas and variably glandu-lar/mucinous related to the degree of differentiation which is usually well to moderate.
— endometrioid: 25% of cervical adenocarcinomas and exclude uterine carcinoma extending to cervix. Typically at the junctional zone arising from endometriosis/endometrial metaplasia and may coexist with usual endocervical type adenocarcinoma. A minimal deviation variant exists.
— minimal deviation (adenoma malignum): late presentation and poor prognosis with bland epithelium showing mitoses and irregular gland extension deep (>50%) into the cervical stroma. CEA and p53 overexpression may be of diagnostic help. Associated with Peutz-Jeghers syndrome.
— villoglandular: good prognosis in young females. Papillary with CGIN type epithelium, connective tissue cores and indolent invasion at base. More aggressive, moderately differentiated variants occur and it can be associated with more usual cervical cancer subtypes. Also consider implantation from an endometrial primary.
— clear cell: clear, hobnail cells, glycogen PAS positive, solid, tubules, papillae; in utero exposure to diethylstilboestrol (50%).
— serous papillary: poor prognosis and potentially multifocal in endometrium and ovary. High-grade cytological appearances ± psam-moma bodies—exclude low-grade villoglandular carcinoma.
— mesonephric: from mesonephric duct remnants deep in the posterior or lateral cervical wall. Small glands with eosinophilic secretions.
— non-Mullerian mucinous: intestinal including colloid and signet ring cell carcinomas. Poor prognosis and exclude gut secondary.
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