Normal Ectocervix Figs

A normal ectocervix is covered by a nonkeratinizing stratified squamous epithelium. Its height is influenced by endogenous hormone production and varies accordingly with age and hormonal stimulation.

During reproductive age (Fig. 3) the epithelium is high and well differentiated. It consists of a basal cell layer with elongated nuclei perpendicular to the basal membrane, of one or several layers of small parabasal cells, of a broad intermediate cell zone with abundant cytoplasmic glycogen, and of a covering layer of narrow, superficial cells.

In childhood and in the postmenopausal period (Fig. 4), because hormonal stimulation is lacking, the squamous epithelium is low. Here it consists only of a few layers of small, poorly differentiated epithelial cells. The sparse cytoplasm is devoid of glycogen; stratification may be barely visible or even absent.

Regardless of their differentiation, all cell layers stain positively for broad-spectrum cytokeratins and, except for the basal cells, for cytokeratins 4 and 13 in appropriate im-

Stained Basal And Parabasal Layers
Fig.3. Normal ectocervix during reproductive age. H&E
Ectocervix Cell
Fig. 4. Normal ectocervix in old age. H&E
Cytoplasmic Cadherin Staining

munohistochemical studies (Fig. 5). Cytokeratin 4 and 13 are normal constituents of epithelial cells in squamous differentiation.

Furthermore, the cell membranes, but not the basal membrane, stain positively with antibodies against E-cadherin (Fig. 6a) and desmoplakin (Fig. 6b). In contrast, the basal cells express cytokeratins of the simple (glandular) epithelial type: 8,18, and 19 (Fig. 7; Franke et al. 1986).

This variation in the expression of cytokeratins by the basal cells may explain their potential for glandular differentiation and for functioning as the germinal layer of the squamous epithelium (Fig. 9). It may also explain their potential to elongate and ramify as protrusions downwards into the underlying fibrous stroma (Fig. 8).

Squamous Cell Ectocervix
Fig. 6. Normal ectocervix. a Immunohistochemical reaction with antibody against E-cadherin. b Im-munohistochemical reaction with antibody against desmoplakin (from Franke et al. 1986)
Ectocervix
Fig.7a-c. Normal ectocervix. Immunohistochemical reaction with cytokeratin PKK 1 (a), 18 (b), and 19 (c). BL basal lamina, LP lamina propria, L lumen (from Franke et al. 1986)

Ramifying protrusions from basal layer into the underlying fibrous stroma. H&E

Ectocervix

Formation of glands from the basal layer of the ectocervical epithelium. H&E

Formation of glands from the basal layer of the ectocervical epithelium. H&E

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