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

Abstract

Objective: Neuroendocrine carcinoma (NEC) of the uterine cervix is a highly aggressive type of tumor. Therefore, recognition of its cytology and histopathology is important for early diagnosis. Study Design: We report 6 cases of small-cell and 6 cases of large-cell NEC of the uterine cervix, including 5 cytology slides. AE1/3, CEA, p63, p16, CD56, chromogranin and synaptophysin were detected. Results: Two cytology slides of small-cell NEC showed sheet-like clusters. The tumor cells were uniformly small, with finely granular chromatin, scant cytoplasm and absent nucleoli. Three large-cell NEC smears showed palisading, molding and abortive rosettes with prominent eosinophilic nucleoli. The tumor cells had either abundant cytoplasm or no cytoplasm at all. The histopathology analysis indicated a transition from dysplasia glands or adenocarcinoma in situ glands to NEC in 6 cases. Conclusion: Cervical cytology of NEC has many unique characteristics, distinct from the characteristics of other lesions. We also demonstrated a hypothesis of the histogenesis of some NECs.

Cytological Diagnoses of Adenocarcinoma in situ of the Cervix: Common Misdiagnoses

“…Only a few glandular cells exhibited atypia in case 13. In case 14, a large-cell neuroendocrine carcinoma (LCNEC) was misdiagnosed as adenocarcinoma, as previously reported [14]. No glandular atypia was observed in case 15.…”

Adenocarcinoma in situ admixed with small cell neuroendocrine carcinoma of the cervix: A case report with cytological features

“…The cytological features of cervical SCNEC are fundamentally the same as those of other organs, such as lung. The neoplastic cells are uniformly small in size (usually <3 times larger than small resting lymphocytes), having scant cytoplasm, fine granular chromatin (“salt and pepper”), inconspicuous nucleoli, and nuclear molding . Moreover, the cytological features of AIS of the present case were also typical: neoplastic cells in form of sheets, clusters, and rosettes in a typically clean background, and feathering appearance (nuclei and cytoplasm protruding from the periphery).…”

“…In one case of adenocarcinoma admixed with SCNEC, HPV‐18 DNA was detected in both components . Moreover, p16, which has been recognized as a putative surrogate marker of high‐risk HPV, is expressed in the majority of cervical SCNEC . Although HPV analysis was not performed in the present case, p16 was diffusely expressed in both AIS and SCNEC components.…”

“…Although the cytological features of cervical SCNEC are characteristics, the cytodiagnosis of this type of tumor may be difficult because of the rarity of the tumor. In a previous study of cervical SCNEC, none cases originally cytological diagnosed as SCNEC were present . In another cytological case study, the accuracy of cervical SCNEC was 38.5%, although Kim et al reported that diagnostic accuracy of SCNEC was 79% (diagnostic or suggested) .…”

“…Cervical small cell neuroendocrine carcinoma (SCNEC) is rare, comprising approximately 2–5% of all cervical cancers, and occasionally having adenocarcinoma and/or squamous cell carcinoma components . SCNEC has not received much attention in cervical cytological examinations because of its rarity .…”