A case of stage ⅠA1 poorly differentiated cervical adenocarcinoma, HPV-associated, with neuroendocrine features

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  • UMEZAWA Takashi
    Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University
  • TATEKAWA Kana
    Department of Pathology, Yokohama City Minato Red Cross Hospital
  • YAMAMOTO Yoko
    Department of Pathology, Yokohama City Minato Red Cross Hospital
  • HAYASHI Eiichi
    Department of Pathology, Yokohama City Minato Red Cross Hospital
  • YAMAMURA Nobukazu
    Department of Pathology, Yokohama City Minato Red Cross Hospital
  • KUMAGAI Jiro
    Department of Pathology, Yokohama City Minato Red Cross Hospital

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Other Title
  • 液状化検体細胞診を用い解析した神経内分泌への分化を伴う HPV 関連子宮頸部低分化型腺癌，ⅠA1 期の 1 例
  • ―Detected by liquid-based cytology―

Abstract

<p>Background : A case of HPV-associated poorly differentiated adenocarcinoma of the cervix, stage ⅠA1, with neuroendocrine differentiation detected by cervical cytology during a comprehensive check-up system.</p><p>Case : The patient was a woman in her 50 s. Liquid-based cytology of the cervix revealed small round or oval tall columnar multinucleated tumor cells with a high N/C ratio, that were scattered singly. The tumor cells had coarse granular nuclear chromatin and prominent nucleoli, and some cells showed mitotic figures or rosette formation. The findings were considered as being consistent with poorly differentiated adenocarcinoma. Tissue specimens obtained by cervical conization showed an early lesion measuring 6 mm in transverse diameter, with a solid growth of tumor cells containing eosinophilic cytoplasm. Gland-like structures were found in some parts. The tumor cell nuclei had increased chromatin, prominent nucleoli, and mitotic or apoptotic figures. The basement membrane at the margin of the tumor nest was partly irregular, and the depth of stromal invasion was judged to be under 3 mm. Immunohistochemistry showed positive staining of the tumor cells for INSM-1, CD56 and p16, and the Ki-67 labeling index was ≥90%.</p><p>Conclusion : The cytological/histological findings were suggestive of poorly differentiated adenocarcinoma of the cervix, stage ⅠA1, with a highly malignant morphology, that required differentiation from large-cell neuroendocrine carcinoma.</p>

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