Ferry J A, Scully R E
Department of Pathology, Harvard Medical School, Boston, Massachusetts.
Am J Surg Pathol. 1988 Feb;12(2):134-44. doi: 10.1097/00000478-198802000-00007.
Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) of the uterine cervix are rare tumors that have often been regarded as a single entity. We studied 28 cases of these neoplasms, with 14 cases in each category. Most patients were over 60 years of age, and there was a high proportion of black women. The majority of the women with ACC presented with postmenopausal bleeding and had an obvious mass on pelvic examination. Despite the tumors' architectural similarity to ACC of the salivary gland, microscopic examination of the cervical carcinomas showed necrosis, a high mitotic rate, and greater nuclear pleomorphism. In all but one of the cases, the tumor cells were negative for S-100 protein on immunoperoxidase staining--a finding that provides evidence against a myoepithelial component. However, S-100-positive dendritic cells were present in the stroma of the tumors and among the neoplastic cells. The patients with ABC were usually asymptomatic, without a gross abnormality of the cervix. Microscopic examination disclosed small nests of basaloid cells, almost always beneath, and often arising from, in situ or small invasive squamous cell carcinomas. In contrast to ABC, ACC was often complicated by local recurrence or distant metastasis. We conclude that ACC of the uterine cervix differs from ACC of salivary gland origin and is also distinct clinically and pathologically from cervical ABC.
子宫颈腺样囊性癌（ACC）和腺样基底细胞癌（ABC）是罕见肿瘤，常被视为单一实体。我们研究了28例此类肿瘤，每类各14例。大多数患者年龄超过60岁，黑人女性比例较高。大多数ACC女性患者表现为绝经后出血，盆腔检查时有明显肿块。尽管这些肿瘤在结构上与涎腺ACC相似，但宫颈癌的显微镜检查显示有坏死、高有丝分裂率和更大的核多形性。除1例病例外，所有病例的肿瘤细胞免疫过氧化物酶染色S-100蛋白均为阴性，这一发现为不存在肌上皮成分提供了证据。然而，肿瘤间质和肿瘤细胞中存在S-100阳性树突状细胞。ABC患者通常无症状，宫颈无肉眼可见异常。显微镜检查发现基底样细胞小巢，几乎总是位于原位或微小浸润性鳞状细胞癌下方，且常由其发生。与ABC不同，ACC常伴有局部复发或远处转移。我们得出结论，子宫颈ACC不同于涎腺来源的ACC，在临床和病理上也与宫颈ABC不同。
