Smear cytology findings of large cell neuroendocrine carcinoma of the uterine cervix

Abstract

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.

Twelve Cases of Neuroendocrine Carcinomas of the Uterine Cervix: Cytology, Histopathology and Discussion of Their Histogenesis

“…Although the cytological diagnosis of SCNEC has been reported frequently, we know of only 4 reported cases of cytological diagnosis of cervical LCNEC [6,7,8,9]. Case 7 in the current report was originally diagnosed as HSIL with features suspicious of invasion (fig.…”

Cytomorphology of unusual primary tumors in the Pap test

“…[121314] It may occur during pregnancy and may also arise from a cervical polyp. [14] The cytomorphology can be mistaken for squamous or adenocarcinoma.…”

“…The nuclei are mildly pleomorphic with coarse chromatin and prominent nucleoli. [1213] Mitotic figures are common and karyorrhectic debris can be identified with no keratinization seen [Figure 5]. Ancillary studies can be performed on cell block material and show positive immunostaining for neuroendocrine markers.…”

Smear cytological features of large cell neuroendocrine carcinoma of the uterine cervix in pregnancy: A case report and review of the literature

“…LCNEC usually first presents itself as vaginal bleeding and there are only four reported cases where a cerviovaginal smear has lead to its detection and diagnosis . Although any comparison of our cytological findings is difficult due to the limited number of cases, they are similar to the LCNECs of the lung.…”