Significance of gross specimen photography

Early cervical cancer often has no obvious symptoms and signs, and the cervix can be smooth or difficult to distinguish from cervical columnar epithelium. Patients with cervical cast are easy to be missed or misdiagnosed because of the normal appearance of the cervix. With the development of the lesion, the following manifestations may appear:

1. Symptoms

(1) The early stage of vaginal bleeding is mostly contact bleeding. Irregular vaginal bleeding in the middle and late stage. The amount of bleeding varies according to the size of the lesion and the invasion of interstitial blood vessels. If it invades large blood vessels, it will lead to massive bleeding. Young patients can also show prolonged menstruation and increased menstrual flow; Irregular vaginal bleeding often occurs in elderly patients after menopause. Generally, exogenous type has symptoms of vaginal bleeding earlier and the amount of bleeding is larger; Endogenous type appears this symptom later.

(2) Vaginal drainage Most patients have vaginal drainage. The liquid is white or bloody, and may be as thin as water or rice, or have a foul smell. A large number of rice soup-like or purulent foul leucorrhea may appear in advanced patients due to cancer necrosis with infection.

(3) The late symptoms have different secondary symptoms according to the degree of tumor involvement. Such as frequent urination, urgency, constipation, swelling and pain of lower limbs, etc. When cancer oppresses or involves ureter, it can cause ureteral obstruction, hydronephrosis and uremia; Anemia, cachexia and other symptoms of systemic failure may occur in the late stage.

2. Symbols

Cancer in situ and minimally invasive cancer can have no obvious macroscopic lesions, smooth cervix or just columnar epithelial heterotopia. With the development of the disease, different symptoms may appear. Exogenous cervical cancer can be seen as polypoid and vegetable-like vegetation, often accompanied by infection, and the tumor is fragile and easy to bleed; Endogenous cervical cancer is characterized by cervical hypertrophy, hardening and enlargement of cervical canal; The advanced cancer tissue is necrotic and falls off, forming ulcers or cavities, which have a foul smell. When the vaginal wall is involved, it can be seen that vegetation grows on the vaginal wall or hardens the vaginal wall; When the periuterine tissue is involved, the thickening, nodulation, hardening or frozen pelvic cavity formation of the pericervical tissue can be detected by Shuanghe needle and three diagnostic methods.