BACKGROUND: Lymphoepithelioma-like carcinoma of the cervix (LELC) is cytologically identical to its counterparts at other sites, such as the nasopharynx. LELC can be suspected on a cervical cytologic smear. The differential diagnosis includes nonkeratinizing squamous cell carcinoma with prominent stromal inflammation, carcinoma with intense stromal eosinophilia, glassy cell carcinoma, malignant lymphoma (especially lymphoepitheloid-Lennerts lymphoma) and metastatic Schmincke-Regaud tumor. CASE: A 55-year-old female presented with an ulcerated endophytic tumor in the cervix. Exfoliative cytology showed uniform, large tumor cells, often associated with inflammatory cells, with round or oval nuclei and one or more prominent nucleoli. The cytoplasm was finely granular to flocculent, and the nuclei were uniformly vesicular. The chromatin was peripherally marginated. The cell borders were indistinct. There was no evidence of dyskeratotic or keratinized cells, koilocytes or glandlike formations. These findings were highly suspicious for LELC and were confirmed by biopsy. Flow cytometry showed DNA aneuploidy, with a DNA index of 1.08. In situ hybridization was negative for human papillomavirus 16 and 18. CONCLUSION: LELC of the uterine cervix has cytologic features that are sufficiently characteristic for a specific cytologic diagnosis. The diagnosis, nevertheless, has to be proven by histology.

Carcinoma, Large Cell↗

PubMedDate not supplied

Exfoliative cytology of invasive neuroendocrine small cell carcinoma in a cervical cytologic smear. A case report.

BACKGROUND: Neuroendocrine small cell carcinoma of the cervix (NSC) is cytologically identical to its counterparts at other sites, such as the lung, and can be suspected on a cervical cytologic smear. It has to be distinguished from poorly differentiated nonkeratinizing squamous small cell carcinoma, adenocarcinoma with carcinoid features, embryonal neuroblastoma, embryonal rhabdomyosarcoma, stromal sarcoma and non-Hodgkin's lymphoma. CASE: An 18-year-old woman had invasive NSC. Exfoliative cytology of the cervix showed tumor cells, single or in small clusters and files, with darkly staining nuclei. The chromatin pattern was coarse, with small, prominent chromocenters, and the nuclei were often invisible. The cytoplasm was so reduced as to be barely discernible. Mutual molding of adjacent nuclei was frequent. Immunohistochemistry showed positive staining for pancytokeratin and neuron-specific enolase. Flow cytometry showed aneuploidy, with a DNA index of 1.93. CONCLUSION: The cytologic appearance of NSC in a cervical cytologic smear is characteristic. The diagnosis, nevertheless, has to be proven by the identification of neuroendocrine differentiation.

Adolescent↗