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 75% 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, 75% 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.