Cytologically, squamous-cell carcinomas of the cervix are subdivided into keratinizing and non-keratinizing types.
Non-keratinizing carcinomas (Figure 37) typically have large numbers of malignant cells that form loose cell sheets and syncytial arrangements. The cells have enlarged nuclei with coarsely clumped chromatin, prominent macronucleoli and focal chromatin clearing. A key cytological feature is the presence of a ‘dirty’ background containing blood and necrotic material. This is often referred to as a tumour diathesis. This characteristic background is usually less prominent in liquid-based cytology specimens.
Cervical smears from women with kera tinizing carcinomas contain malignant cells of a variety of shapes and sizes (Figure 38). Some of the cells are pleomorphic or tadpole-shaped with nuclei that are irregular in shape and quite hyper chromatic. U nlike non-keratinizing squamous-cell carcinoma, keratinizing squamous-cell carcinomas usually do not have a ‘dirty’ background or evidence of tumour diathesis.