Signi.cance of Cytologic Smears in the Diagnosis of Small Cell Carcinoma of the Uterine Cervix

Kim, Yoonjung; Ha, Hwa Jeong; Kim, Jung Soon; Chung, Jin Haeng; Koh, Jae Soo; Park, Sunhoo; Lee, Seung Sook

doi:10.1159/000326968

Cited by 15 publications

(33 citation statements)

References 12 publications

(11 reference statements)

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“…A total of 82 early-stage SCCUC patients who had undergone SU with or without adjuvant therapy were identified by a search on PubMed (3,4,9,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The total number of patients for analysis was 96.…”

Section: Resultsmentioning

confidence: 99%

Prognostic factors and treatment comparison in early-stage small cell carcinoma of the uterine cervix

2011

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Abstract. Small cell carcinoma of the uterine cervix (SCCUC) is rare and its biologic behavior is aggressive. To analyze prognostic factors and determine optimal therapy in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA SCCUC, we retrospectively reviewed 96 patients (14 patients treated in our center and 82 patients identified by a search on PubMed) treated with radical surgery (SU), surgery plus adjuvant chemotherapy (SU+Chemo), or surgery plus adjuvant chemotherapy and radiotherapy (SU+Chemo+RT) between 1990 and 2010. Of the 96 patients, 11 patients were treated with SU, 33 with SU+Chemo, and 52 with SU+Chemo+RT. The 5-year survival rate for the 96 patients was 45%. A total of 6% (2/32) of patients had local recurrence, 75% (24/32) had distant metastases, and 19% (6/32) had both. The 5-year survival rate in stage IB1 and IB2-IIA disease was 58 and 34%, respectively (P=0.049). For patients with and without lymph node metastases (LNM), survival was 33 and 60%, respectively (P=0.045). Patients with inner 1/3 stromal invasion had a better survival than those with deep stromal invasion (DSI) (100 vs. 34%, P=0.003). Survival was not significantly different in patients treated with the above three modalities, albeit treatment selection was related to LNM (P=0.000) and DSI (P=0.027). Thus, FIGO stage, LNM and DSI are significant predictors of survival. Adjuvant therapy after SU has not improved survival compared with surgery alone. Thus, newer multimodality therapy should be evaluated.

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Section: Resultsmentioning

confidence: 99%

Prognostic factors and treatment comparison in early-stage small cell carcinoma of the uterine cervix

2011

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“…3 The diagnostic accuracy of our institution is 38.5%. One case was diagnosed as within normal limits and showed no malignant cells, this smear is inadequate for diagnosis due to low cellularity.…”

Section: Discussionmentioning

confidence: 79%

“…Median age is older than 42 years of Gersell and his colleagues' study. In the previous studies, low detection rate of SMCC can be understood by the rarity, 3 subepithelial tumor cell growth pattern with preserved normal epithelium, and relatively high endocervical location. 13 Forty-six percent and 14% of cases were diagnosed as ''abnormal'' or ''malignant'' by Wang et al and Zhou et al, respectively, and nearly no case was diagnosed as SMCC.…”

Section: Discussionmentioning

confidence: 98%

“…1 SMCC of the cervix is a highly aggressive tumor. 2,3 The prognosis of this tumor is worse than its well-differentiated carcinoid counterpart and that of stage-comparable, poorly differentiated squamous cell carcinoma. 2,4,5 The majority of reported patients have died of disease within 2-3 years of diagnosis.…”

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confidence: 99%

“…[9][10][11] Diagnosis by cervical cytologic smear is important for early treatment and better prognosis. [1][2][3]9,11,12 But the cytologic differential diagnostic characteristics for SMCC are rarely described in the texts and papers.…”

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confidence: 99%

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Differential diagnostic features of small cell carcinoma in the uterine cervix

Kim

Cho

et al. 2008

Diagnostic Cytopathology

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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.

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Small cell carcinoma of the cervix in liquid‐based Pap test: Utilization of split‐sample immunocytochemical and molecular analysis

Giorgadze

Kanhere

Pang

et al. 2010

Diagnostic Cytopathology

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Small cell (neuroendocrine) carcinoma of the uterine cervix (SMCC) is a rare, highly aggressive malignant neoplasm. Both conventional and liquid-based cytology (LBC) cervical smears have low sensitivity in diagnosing SMCC, requiring immunocytochemical (ICH) confirmation. We present the first series of SMCC primarily diagnosed in cytology specimens, and ICH studies performed on the residual LBC specimens with subsequent confirmation of the diagnosis on surgical pathology specimens. Immunocytochemical stains for keratin, p16INK4, and neuroendocrine markers (synaptophysin, chromogranin, CD56) were performed on additional ThinPrep slides. HPV test used chromogenic in situ hybridization high risk HPV DNA probe. The Pap smears in all three specimens were highly cellular with a mixture of squamous cells and numerous well-preserved single or small cohesive clusters of malignant epithelial cells. Tumor cells were small, monomorphic with minimal cytoplasm and high nuclear/cytoplasmic ratio. There was significant nuclear overlap, but no nuclear molding, or smudging of nuclear chromatin. The chromatin pattern was stippled. A background tumor diathesis was prominent. Atypical squamous cells of undetermined significance (ASCUS) were noted in one case, and markedly abnormal squamous cells were seen in another case. The main cytology differential diagnoses included high-grade squamous intraepithelial lesion and an endometrial adenocarcinoma. Immunocytochemical positivity for the neuroendocrine markers supported the diagnoses of SMCC in all three cases. The morphologic features of the concurrent surgical pathology specimens were typical of SMCC. The tissue diagnoses were also confirmed by immunohistochemistry. Our study allows us to conclude that SMCC can be primarily diagnosed in LBC specimens using a panel of immunocytochemical stains.

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Signi.cance of Cytologic Smears in the Diagnosis of Small Cell Carcinoma of the Uterine Cervix

Cited by 15 publications

References 12 publications

Prognostic factors and treatment comparison in early-stage small cell carcinoma of the uterine cervix

Prognostic factors and treatment comparison in early-stage small cell carcinoma of the uterine cervix

Differential diagnostic features of small cell carcinoma in the uterine cervix

Small cell carcinoma of the cervix in liquid‐based Pap test: Utilization of split‐sample immunocytochemical and molecular analysis

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