Kim Min Jung, Kim Na Rae, Cho Hyun Yee, Lee Soon Pyo, Ha Seung Yeon
Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea.
Diagn Cytopathol. 2008 Sep;36(9):618-23. doi: 10.1002/dc.20875.
Small cell carcinoma (SMCC) of the uterine cervix is rare and known to be an aggressive tumor, but there are only few reports on the cytologic features of cervical SMCC. This rare small cell lesion should be distinguished from malignant lymphoma (ML), squamous cell carcinoma in situ (SCIS), and chronic lymphocytic cervicitis (CLC). By clarifying cytologic features and reevaluating the significance of cervical cytologic smears to reveal these cervical lesions, we can improve the diagnostic specificity and patient's outcome. The clinical record and available cervical smears from 13 cases of SMCC, four cases of malignant lymphoma, 20 cases of SCIS, and five cases of CLC were analyzed. The cytologic differential diagnostic points of SMCC were nuclear molding and smearing (100%), salt and pepper chromatin (100%), exudative and necrotic background (91.7%), various architectures including individual cells (83.3%), tight clusters (75%) and feathering and strip (50%), and inconspicuous nucleoli (75%). Early diagnosis of the cervical SMCC by cytology and treatment is important for better outcome of patients.
子宫颈小细胞癌(SMCC)罕见,是一种侵袭性肿瘤,但关于宫颈SMCC细胞学特征的报道较少。这种罕见的小细胞病变应与恶性淋巴瘤(ML)、原位鳞状细胞癌(SCIS)和慢性淋巴细胞性宫颈炎(CLC)相鉴别。通过明确细胞学特征并重新评估宫颈细胞学涂片对揭示这些宫颈病变的意义,我们可以提高诊断特异性和患者的治疗效果。对13例SMCC、4例恶性淋巴瘤、20例SCIS和5例CLC的临床记录及可用宫颈涂片进行了分析。SMCC的细胞学鉴别诊断要点为核塑形和涂片(100%)、椒盐样染色质(100%)、渗出性和坏死性背景(91.7%)、包括单个细胞(83.3%)、紧密团块(75%)以及羽毛状和条索状(50%)在内的各种结构,以及不明显的核仁(75%)。通过细胞学检查早期诊断宫颈SMCC并进行治疗对患者获得更好的治疗效果很重要。