case_images: PMC10851099_01
case_images: Histopathology of the cervical biopsy. A: diffuse proliferation of neoplastic cells, H&E stain, original magnification 40x; B: nested growth pattern of atypical cells, H&E stain, original magnification 100x; C: intervening vascularized stroma, H&E stain, original magnification 200x; D: highly atypical squamous cells, H&E stain, original magnification 400x. H&E: hematoxylin and eosin
case_images: cureus-0016-00000051922-i01.jpg
case_images: PMC10851099_01_cureus-0016-00000051922-i01.jpg
case_images: FIG1
case_images: Colposcopy revealed a 5 mm exophytic lesion on the exocervix, which was biopsied, with histopathology showing a SCC (Figure 1).
case_images: Histopathology of the cervix from the total hysterectomy specimen. Dysplastic changes in the superficial epithelium (blue asterisk) and invasive nests (orange arrow), H&E stain, original magnification 40x (A), 100x (B), 200x (C), and 400x showing highly atypical squamous cells within the invasive nests, original magnification 400x (D), H&E stains. H&E: hematoxylin and eosin
case_images: cureus-0016-00000051922-i02.jpg
case_images: PMC10851099_01_cureus-0016-00000051922-i02.jpg
case_images: FIG2
case_images: After histopathology, a decision for total hysterectomy was taken, with histology showing again invasive SCC of the uterine cervix with a depth of invasion of 4 mm, staged as pT1B1 and International Federation of Gynecology and Obstetrics/Federation Internationale de Gynecologie et d'Obstetrique (FIGO) IB1 (Figure 2).
case_images: PMC10851099_02
case_images: PMC10851099_03
case_images: PMC10851099_04
case_images: Histopathology and immunophenotype of the resected pulmonary lesion. A: nest comprised of highly atypical cells surrounding the cartilage of a large bronchus (asterisk), H&E stain, original magnification x40; B: involvement of a peribronchial lymph node with extensive anthracosis (asterisk), H&E stain, original magnification x40; C: p40 positive stain in tumor cells, original magnification x40; D: PDL1 positive staining in 20% of tumor cells, original magnification x40. H&E: hematoxylin and eosin; p40: Delta Np63 isoform; PDL1: programmed death ligand 1
case_images: cureus-0016-00000051922-i03.jpg
case_images: PMC10851099_04_cureus-0016-00000051922-i03.jpg
case_images: FIG3
case_images: Immunohistochemically, the tumor expressed Delta Np63 isoform (p40) and did not express thyroid transcription factor 1 (TTF1) (Figure 3). The tumor involved both the bronchial wall and an adjacent peribronchial lymph node and showed foci of perineural growth; a further 21 histologically evaluated lymph nodes showed no other metastatic involvement (Figure 3).
case_images: p16 expression in both cervical (A) and pulmonary (B) lesions. p16: tumor suppressor protein encoded by cyclin-dependent kinase N2A (CDKN2A)
case_images: cureus-0016-00000051922-i04.jpg
case_images: PMC10851099_04_cureus-0016-00000051922-i04.jpg
case_images: FIG4
case_images: Immunohistochemical evaluation of tumor suppressor protein encoded by cyclin-dependent kinase N2A (p16) came back positive in the cervical and pulmonary specimens, confirming the HPV association of both SCCs (Figure 4).
case_images: PMC10851099_05