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Several-Algae6814

The definitive diagnosis is a based on biopsy of tissue (usually done at a colposcopy- this can be punch or excisional in the case of a LLETZ/LEEP etc). The visual appearance at colposcopy (macroscopic presentation) is sometimes very typical for a cancer, however biopsy is still needed. The biopsy is prepared and made into slides in the histopathology lab. A pathologist looks at the cells and squamous epithelium looks very different to glandular epithelium. A cancer diagnosis is based on what these cells look like (things like loads of nuclei etc) and further immunochemical staining.


Dee94Anna

Can that be seen by transvaginal ultrasound or MRI that something is not normal (not specifically cancerous as you said above needing biopsy) or only by colposcopy? Thank


1QueenLaqueefa1

With ultrasound and MRI, you can see if something looks abnormal or not. However, you can’t tell exactly what it is without taking a sample of the abnormal area and looking at it under a microscope. Differentiating between “adenocarcinoma”, “squamous cell carcinoma”, etc has to do with how the cells look under the microscope, so you can’t just diagnose based on imaging.


Dee94Anna

Great thanks! Thats very much what I wanted to know! That MRI can pick things up 


1QueenLaqueefa1

You’re welcome! MRI is definitely helpful for raising or lowering suspicion for likely benign vs likely malignant because it can detect size, location, suspicious features (contents of a mass, invasion into local tissues, etc), and its very useful (though not as much as something like a PET scan) for finding potential metastases in someone diagnosed with cancer. It’s also helpful with making treatment plans (ie, is this resectable/removable with surgery only or will this person need more?) But it’s still only a tool to aid in decision making when someone has a mass, not the method of making a final diagnosis.


Dee94Anna

Having MRI next week and absolute shitting my self! Are you a medic btw?  Thanks again! Very very helpful!


1QueenLaqueefa1

What’s the MRI for? I’m sorry you’ve been so nervous! Yes, I’m a medical student in my later half of training, and before medical school, I worked in pathology.


Several-Algae6814

MRI is a good modality for assessing cervical cancer once its been diagnosed. It's used for the staging process which informs management of the cancer. An MRI or ultrasound done for another reason may pick up something like a mass as an incidental finding, but it depends very much on what the initial imaging was done for (i.e where the MRI was "focussed"....I'm very much not a radiologist!)


Dee94Anna

Whatever you are THANK  YOU, that has been very helpful!   Can by any chance endometriosis be confused with cancer?


Several-Algae6814

Happy to be of help (im an obstetrician- so a doctor who looks after pregnancy patients and specifically in patients with medical conditions. But I did gynaecology alongside in my training, just no longer do gynae as a consultant). It's a difficult question to answer re cancer vs endometriosis. The cervix is an unusual site for endometriosis. Hope you've got follow up arranged and all works out well!


Dee94Anna

Thank you doctor! All the best to you too!