506 Obstetrics and Gynecology Board Review •••
❍ What is the most common type of HPV associated with flat condylomas of the cervix?
Types 6 and 11.
❍ What is the most common type of HPV found in high-grade squamous intraepithelial lesions and invasive
carcinomas of the cervix?
Type 16.
❍ What is the classic colposcopic appearance of a high-grade squamous intraepithelial lesion of the cervix?
A mosaic pattern.
❍ What is the classic colposcopic appearance of an invasive carcinoma of the cervix?
Irregular, tortuous blood vessels extending across the cervix.
❍ Is HPV found in association with adenocarcinoma in situ of the cervix?
Yes. HPV types 16 and 18 have been found in adenocarcinoma in situ of the cervix indicating a possible causal
factor in development of adenocarcinoma of the cervix.
❍ What is the most common cause of death in patients with cervical carcinoma?
Cervical carcinoma tends to spread locally and via lymphatics, not hematogenously. Thus, the ureters are frequently
obstructed resulting in hydronephrosis, pyelonephritis, and renal failure that are the most common causes of death.
❍ What types of HPV have been isolated in verrucous carcinoma of the vagina/vulva?
Types 6 and 16.
❍ Describe the behavior of adenoid cystic carcinoma of the cervix.
This is a rare cervical tumor that is very aggressive and exhibits local recurrence with distant metastases. The
prognosis is similar or worse than the more conventional squamous cell carcinoma of the cervix.
❍ Does the prognosis for adenoid cystic carcinoma of the cervix differ from adenoid basal carcinoma of the cervix?
Yes. Markedly, therefore it is critical to make the histologic distinction between the two tumors. Adenoid basal
carcinomas exhibit a benign behavior with no metastases.
❍ What is the pattern of spread and prognosis in papillary villoglandular adenocarcinoma of the cervix?
This unusual tumor is found in younger women and, although it can be deeply invasive, it does not appear to
metastasize.
❍ What is the name of the benign lesion of the cervix that is composed of a nodular, circumscribed aggregate
of dilated endocervical glands that are superficially located beneath the epithelial surface?
Tunnel clusters.
❍ How common is an associated squamous dysplastic lesion of the cervix found in association with
adenocarcinoma in situ of the cervix?
Very common, ranging from 50% to nearly 100% in a variety of studies.