Invasive cervical carcinoma may manifest as fungating (exophytic) or infiltrative masses. Squamous cell carcinoma is composed of nests and tongues of malignant squamous epithelium, either keratinizing or nonkeratinizing, which invade the underlying cervical stroma (Fig. 22.16A–B). Adenocarcinoma is characterized by proliferation of glandular epithelium composed of malignant endocervical cells with large, hyperchromatic nuclei and relatively mucin-depleted cytoplasm, resulting in a dark appearance of the glands, as compared with the normal endocervical epithelium