Miles P A, Herrera G A, Greenberg H, Rawding-Patterson G
Diagn Gynecol Obstet. 1982 Winter;4(4):327-37.
Primary carcinoid tumors of the uterine cervix are uncommon gynecologic neoplasms. An unusual case of this neoplasm is presented that was originally diagnosed as a poorly differentiated adenosquamous cervical carcinoma. A subsequent metastatic pulmonary nodule was discovered 13 months later with the unexpected histologic and ultrastructural features of a carcinoid tumor. The primary cervical malignancy was reassessed ultrastructurally and the original diagnosis was changed to that of a poorly differentiated carcinoid tumor. By using immunoperoxidase techniques, it was observed that serotonin granules were present in the neoplastic cells of the lung and cervix, confirming the carcinoid nature of the tumor. This case differs from the majority of those reported as poorly differentiated cervical carcinoids in that it did not resemble an undifferentiated small cell (oat cell) carcinoma, but was more typical of an adenosquamous carcinoma. This case supports the role of electron microscopy and immunohistochemistry in the complete evaluation and diagnosis of less-differentiated cervical neoplasms in order to specifically identify the primary cell (cells) of origin. Only in this way can one definitively support the diagnosis of a primary carcinoid tumor and perhaps, with this knowledge, the clinicobiologic behavior of this cancer can be altered and possibly improved by initiating different or adjunctive treatment modalities.
子宫颈原发性类癌肿瘤是罕见的妇科肿瘤。本文报告了一例该肿瘤的不寻常病例，最初被诊断为低分化腺鳞癌。13个月后发现一个转移性肺结节，具有类癌肿瘤意外的组织学和超微结构特征。对原发性宫颈恶性肿瘤进行了超微结构重新评估，原诊断改为低分化类癌肿瘤。通过免疫过氧化物酶技术观察到，肺和宫颈肿瘤细胞中存在血清素颗粒，证实了肿瘤的类癌性质。该病例与大多数报告的低分化宫颈类癌不同，它不像未分化小细胞（燕麦细胞）癌，而更像是腺鳞癌。该病例支持电子显微镜和免疫组织化学在低分化宫颈肿瘤的完整评估和诊断中的作用，以便明确识别起源的原始细胞。只有这样才能明确支持原发性类癌肿瘤的诊断，也许基于这一认识，通过启动不同或辅助治疗方式，可以改变并可能改善这种癌症的临床生物学行为。
