Kuroda Naoto, Wada Yukari, Inoue Kaori, Ohara Masahiko, Mizuno Keiko, Toi Makoto, Tanaka Azusa, Wani Yoji, Yanai Hiroyuki
Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan.
Diagn Cytopathol. 2013 Jul;41(7):636-9. doi: 10.1002/dc.21834. Epub 2011 Oct 11.
Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is a rare tumor. Moreover, there are only three reports to date that have focused on the cytologic findings of cervical LCNEC. We report the case of a 59-year-old Japanese woman with cervical LCNEC combined with small cell carcinoma (SmCC). Cytologic specimens from the uterine cervix demonstrated large cells with coarse chromatin and prominent nucleoli. Frequent mitotic figures were also observed. Curettage of the uterine endometrium revealed an endometrioid adenocarcinoma with squamous differentiation; i.e., an adenoacanthoma. Histologic examination of surgically resected uterine cervical tissue revealed LCNEC with minor foci of SmCC. Neuroendocrine differentiation in LCNEC was confirmed by immunohistochemistry for synaptophysin and CD56. Cytotechnologists or pathologists need to consider a differential diagnosis of LCNEC while examining cervical cytologic specimens; therefore, it is important to correctly identify the cytologic characteristics of this tumor.
宫颈大细胞神经内分泌癌（LCNEC）是一种罕见肿瘤。此外，迄今为止仅有三篇报道聚焦于宫颈LCNEC的细胞学表现。我们报告一例59岁日本女性宫颈LCNEC合并小细胞癌（SmCC）的病例。宫颈细胞学标本显示细胞体积大，染色质粗糙，核仁突出。还观察到频繁的有丝分裂象。子宫内膜刮除术显示为伴有鳞状分化的子宫内膜样腺癌，即腺棘皮瘤。手术切除的宫颈组织的组织学检查显示为LCNEC，伴有少量SmCC灶。通过突触素和CD56免疫组化证实LCNEC存在神经内分泌分化。细胞技术人员或病理学家在检查宫颈细胞学标本时需要考虑LCNEC的鉴别诊断；因此，正确识别该肿瘤的细胞学特征很重要。
