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宫颈低分化鳞状细胞癌伴肉瘤样分化:1例细胞组织学相关性报告

Poorly differentiated squamous cell carcinoma of the cervix with sarcomatoid differentiation: Report of a case with cytohistological correlation.

作者信息

Akhtar Israh, Flowers Rhyne, Nuttli Theresa, Nath Vikas, Baliga Mithra

机构信息

Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi.

出版信息

Diagn Cytopathol. 2017 Feb;45(2):137-142. doi: 10.1002/dc.23612. Epub 2016 Sep 27.

DOI:10.1002/dc.23612
PMID:27669672
Abstract

Sarcomatoid squamous cell carcinoma (SSCC) of the uterine cervix is a rare malignancy with uncertain pathogenesis and aggressive clinical behavior. The diagnosis of this tumor poses a challenge to the cytopathologist since accurate diagnosis is based on identification of two malignant components, that is, epithelial and sarcomatoid. Most cases usually lack the sarcomatoid component on Papanicolaou test (Pap test). Therefore, a poorly differentiated carcinoma or malignant neoplasm is the most often rendered diagnosis. To date, less than 20 cases have been reported. Most of these cases were diagnosed by histopathologic findings. To our knowledge, cytomorphologic findings of SSCC on a liquid-based Pap test, with utility of cell block sections, in recognition of the two components of tumor, with follow-up histopathologic correlation have not been described. A case of SSCC occurring in a 57-year-old postmenopausal woman, describing the cytologic features on a liquid-based Pap-test, histopathologic findings of subsequent cervical biopsy, differential diagnosis, and role of ancillary studies are illustrated and discussed. Diagn. Cytopathol. 2017;45:137-142. © 2016 Wiley Periodicals, Inc.

摘要

子宫颈肉瘤样鳞状细胞癌(SSCC)是一种罕见的恶性肿瘤,其发病机制尚不明确,临床行为具有侵袭性。该肿瘤的诊断对细胞病理学家来说是一项挑战,因为准确诊断基于识别两种恶性成分,即上皮成分和肉瘤样成分。大多数病例在巴氏涂片检查(Pap检查)中通常缺乏肉瘤样成分。因此,最常做出的诊断是低分化癌或恶性肿瘤。迄今为止,报道的病例不到20例。这些病例大多通过组织病理学检查确诊。据我们所知,尚未有关于液基Pap检查中SSCC的细胞形态学表现、细胞块切片在识别肿瘤两种成分中的作用以及后续组织病理学相关性的报道。本文展示并讨论了一例发生在57岁绝经后女性的SSCC病例,描述了液基Pap检查的细胞学特征、后续宫颈活检的组织病理学结果、鉴别诊断以及辅助检查的作用。《诊断细胞病理学》2017年;45:137 - 142。© 2016威利期刊公司

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