Three cases of coexisting glandular and squamous lesions of the uterine cervix

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  • SAKAMOTO Takahiro
    Department of Obstetrics and Gynecology, Self Defense Forces Central Hospital
  • KATO Masafumi
    Department of Obstetrics and Gynecology, Self Defense Forces Central Hospital
  • KATO Kento
    Department of Obstetrics and Gynecology, Self Defense Forces Central Hospital
  • YOSHINAGA Yousuke
    Department of Obstetrics and Gynecology, Self Defense Forces Central Hospital
  • TAKEO Hiroaki
    Department of Diagnostic Pathology, Self Defense Forces Central Hospital
  • TAKANO Masashi
    Department of Obstetrics and Gynecology, National Defense Medical College Hospital

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  • 子宮頸部に扁平上皮病変と腺系病変が共存した子宮頸部上皮性腫瘍の 3 例

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Abstract

<p>Background : Adenocarcinoma of the uterine cervix currently accounts for approximately 20% of all cervical cancers, and its incidence has been increasing, particularly in young women. In general, diagnosis is more difficult when glandular and squamous components coexist than when either lesion exists alone.</p><p>Cases : Case 1 is a 38-year-old woman, in whom the findings on cervical Papanicolaou (PAP) smears were categorized as high-grade squamous intraepithelial lesion (HSIL). Histological diagnosis after conization revealed coexistence of adenocarcinoma in situ (AIS) and cervical intraepithelial neoplasia 3 (CIN3). Case 2 is a 51-year-old woman, in whom the findings on cervical PAP smears were suggestive of AIS. Histological diagnosis after conization showed coexistence of AIS and CIN1. Case 3 is a 43-year-old woman, in whom the findings on cervical PAP smears were reported as “atypical squamous cells, cannot exclude HSIL (ASC-H) and atypical glandular cells, not otherwise specified.” Histological diagnosis after conization revealed coexistence of stage IA2 microinvasive adenocarcinoma and CIN3. Definitive surgery was performed in all three patients after the conization.</p><p>Conclusion : We report the clinicopathological characteristics of three cases of synchronous squamous and glandular lesions that were treated by definitive surgery. However, it is difficult to detect coexisting glandular and squamous lesions of the uterine cervix, and when glandular abnormality is suspected from cytology or HPV typing test, closer investigation is warranted to determine possible coexistence of glandular and squamous lesions.</p>

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