Adenoid Basal Carcinoma of the Uterine Cervix in Association with Keratinizing Squamous Cell Carcinoma: a Rare Diagnosis

Abstract Objective. Histiocytic sarcoma (HS) is an extraordinary rare tumor and it has an offensive clinical course. HS of the uterine cervix is a far uncommon tumor with just a few cases described so far. Here we presented a case of primary HS of the uterine cervix in a 62-year-old female initially misdiagnosed as large cell non-keratinizing squamous cell carcinoma. To the best of our knowledge, this is the first reported case of HS of the uterine cervix from Iran. Case report. The patient presented with post-menopausal vaginal bleeding. Further evaluations revealed the presence of a relatively large cervical mass that was sampled. Under the preliminary diagnosis of large cell non-keratinizing squamous cell carcinoma, the patient underwent radical surgery. Postoperative pathological examination confirmed the diagnosis of HS of the uterine cervix. The patient received chemotherapy. Conclusion. Clinical presentations of HS of the uterine cervix are very similar to more common cervical tumors; as a result its diagnosis relies on immunohistochemical methods. A correct diagnose could lead to the proper and timely treatment.

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Immunohistochemical expression of P16 and Ki-67 in uterine cervical neoplasms

IP Journal of Diagnostic Pathology and Oncology ◽

10.18231/j.jdpo.2021.042 ◽

2021 ◽

Vol 6 (3) ◽

pp. 194-200

Author(s):

Kafil Akhtar ◽

Shafaque Zabin ◽

Zehra Mohsin ◽

Shahid A Siddiqui

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Uterine Cervix ◽

Invasive Carcinoma ◽

Large Cell ◽

Carcinoma Cervix ◽

Ki 67 ◽

Early Detection Of Disease ◽

Keratinizing Squamous Cell Carcinoma

To study the expression of Ki-67 and p16 in neoplastic lesions of uterine cervix and to evaluate the prognostic significance of tumour differentiation, histological type, stage and grade, depth of tumour invasion and lymphovascular invasion in women with neoplasia of uterine cervix. This study was performed on 50 biopsies and surgically resected specimens of uterine cervix, which were fixed in 10% formalin, processed, paraffin embedded and cut into 3-5 microns thickness, stained with hematoxylin and eosin stains and immunohistochemical staining by p16 and Ki-67 antibodies was performed and studied. Majority of cases of invasive carcinoma cervix were large cell non-keratinizing squamous cell carcinoma, 58 cases (48.2%). Majority of cases of invasive carcinoma cervix were seen in stage 2B, 40 (40.8%) cases followed by stage 3B, 24 (24.4%) cases. Out of 18 cases of large cell non-keratinizing squamous cell carcinoma, 12 (66.7%) showed 3+ positivity for Ki-67. 7 (53.8%) cases of stage 2A showed 3+ positivity, 3 (23.1%) cases each showed 2+ positivity for p16. 7 (36.8%) cases of moderately differentiated SCC showed 3+ positivity, 4 (21.1%) showed 2+ positivity and 5 (26.3%) showed 1+ positivity of Ki-67. Out of 10 stable patients, 4 (40.0%) showed negative p16 immunoexpression and all the 3 cases (100%) with recurrence showed 2+ positivity and 2 (100%) patients with metastasis showed 3+ positivity. Out of 10 stable patients, 6 (60%) showed negative Ki-67 immunoexpression and all the 3 (100%) cases with recurrence showed 3+ positivity and one each (50.0%) patient with metastasis showed 2+ positivity and 3+ positivity. p16 and Ki-67 immunomarkers are useful as a diagnostic and prognostic tool in cases with recurrence and metastasis, helping in early detection of disease progression.

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Adenosquamous carcinoma of the uterine cervix displaying tumor-associated tissue eosinophilia

SAGE Open Medical Case Reports ◽

10.1177/2050313x19828235 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1982823

Author(s):

Nozomu Kurose ◽

Seiya Mizuguchi ◽

Yoshiiku Ohkanemasa ◽

Manabu Yamashita ◽

Mariko Nakano ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Cells ◽

Squamous Cell ◽

Uterine Cervix ◽

Adenosquamous Carcinoma ◽

Tissue Eosinophilia ◽

Tumor Tissues ◽

Keratinizing Squamous Cell Carcinoma ◽

Endometrial Cytology

Background: Tumor-associated tissue eosinophilia is defined as an inflammatory response with the marked infiltration of eosinophils within tumor tissues. Tumor-associated tissue eosinophilia has been reported in various organs; however, no studies have examined the detailed cytopathological findings of tumor-associated tissue eosinophilia. Case Presentation: A 49-year-old woman presented with lower abdominal and back pain that had started 1 month earlier. A cervical biopsy revealed a diagnosis of non-keratinizing squamous cell carcinoma. A mildly increased number of eosinophils was observed in both cervical cytology and a biopsy. On pelvic computed tomography, a tumor mass measuring up to 5.5 cm in the largest diameter was seen in the uterine cervix. After 1 month, endometrial cytology was performed, and non-keratinizing squamous cell carcinoma together with normal endometrial glands was obtained in a background of marked eosinophil numbers. Tumor cells in an irregular-shaped solid nest had variable-sized hyperchromatic nuclei and light-green-stained cytoplasm. The number of eosinophils was obviously increased. Considering the possibility of tumor-associated tissue eosinophilia, we evaluated a peripheral blood sample and confirmed an increased number of eosinophils. Radical hysterectomy was performed, and the final pathological diagnosis was adenosquamous carcinoma. Although the number of eosinophils decreased after surgery, it increased again at the time of recurrence 1 year later. Chemo-irradiation was performed, but the patient died 1 year and 8 months after the operation. Conclusion: Cytopathologists should consider the presence of tumor-associated tissue eosinophilia by focusing on not only tumor cells but also the markedly eosinophilic background. The eosinophil count might be a useful marker of the disease activity.

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