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.

1.
Crowder S, Tuller E: Small cell carcinoma of the female genital tract. Semin Oncol 2007;34:57–63.
2.
Viswanathan AN, Deavers MT, Jhingran A, Ramirez PT, Levenback C, Eifel PJ: Small cell neuroendocrine carcinoma of the cervix: outcome and patterns of recurrence. Gynecol Oncol 2004;93:27–33.
3.
Wells M, Nesland JM, Ostor AG, Goodman AK, Crum CP, Sankaranarayanan R, Franceschi S, Hanselaar AG, Tommasino M, Albores-Saavedra J: Epithelial tumours; in Tavassoli FA, Devilee P: World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of the Breast and Female Genital Organs. Lyon, IARC Press, 2003, pp 262–279.
4.
Albores-Saavedra J, Gersell D, Gilks CB, Henson DE, Lindberg G, Santiago H, Scully RE, Silva E, Sobin LH, Tavassoli FJ, Travis WD, Woodruff JM: Terminology of endocrine tumors of the uterine cervix: results of a workshop sponsored by the College of American Pathologists and the National Cancer Institute. Arch Pathol Lab Med 1997;121:34–39.
5.
Cohen JG, Kapp DS, Shin JY, Urban R, Sherman AE, Chen LM: Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients. Am J Obstet Gynecol 2010;203:347.e1–e6.
6.
Niwa K, Nonaka-Shibata M, Satoh E, Hirose Y: Cervical large cell neuroendocrine carcinoma with cytologic presentation: a case report. Acta Cytol 2010;54(suppl 5):977–980.
7.
Lee WY: Exfoliative cytology of large cell neuroendocrine carcinoma of the uterine cervix. Acta Cytol 2002;46:1176–1179.
8.
Kuroda N, Wada Y, Inoue K, Ohara M, Mizuno K, Toi M, Tanaka A, Wani Y, Yanai H: Smear cytology findings of large cell neuroendocrine carcinoma of the uterine cervix. Diagn Cytopathol 2011 DOI: 10.1002/dc.21834.
9.
Dikmen Y, Kazandi M, Zekioglu O, Ozsaran A, Terek MC, Erhan Y: Large cell neuroendocrine carcinoma of the uterine cervix: a report of a case and review of the literature. Arch Gynecol Obstet 2004;270:185–188.
10.
Ronnett BM, Yemelyanova AV, Vang R, Gilks CB, Miller D, Gravitt PE: Endocervical adenocarcinomas with ovarian metastases: analysis of 29 cases with emphasis on minimally invasive cervical tumors and the ability of the metastases to simulate primary ovarian neoplasms. Am J Surg Pathol 2008;32:1835–1853.
11.
McCluggage WG, Shah R, Connolly LE, McBride HA: Intestinal-type cervical adenocarcinoma in situ and adenocarcinoma exhibit a partial enteric immunophenotype with consistent expression of CDX2. Int J Gynecol Pathol 2008;27:92–100.
12.
Riethdorf L, O’Connell JT, Riethdorf S, Cviko A, Crum CP: Differential expression of MUC2 and MUC5AC in benign and malignant glandular lesions of the cervix uteri. Virchows Arch 2000;437:365–371.
13.
Mikami Y, Kiyokawa T, Hata S, Fujiwara K, Moriya T, Sasano H, Manabe T, Akahira J, Ito K, Tase T, Yaegashi N, Sato I, Tateno H, Naganuma H: Gastrointestinal immunophenotype in adenocarcinomas of the uterine cervix and related glandular lesions: a possible link between lobular endocervical glandular hyperplasia/pyloric gland metaplasia and ‘adenoma malignum’. Mod Pathol 2004;17:962–972.
14.
Utsugi K, Hirai Y, Takeshima N, Akiyama F, Sakurai S, Hasumi K: Utility of the monoclonal antibody HIK1083 in the diagnosis of adenoma malignum of the uterine cervix. Gynecol Oncol 1999;75:345–348.
15.
Kojima A, Mikami Y, Sudo T, Yamaguchi S, Kusanagi Y, Ito M, Nishimura R: Gastric morphology and immunophenotype predict poor outcome in mucinous adenocarcinoma of the uterine cervix. Am J Surg Pathol 2007;31:664–672.
16.
Kurman RJ, Norris HJ, Wilkinson EJ: Tumor-like lesions; in Kurman RJ, Norris HJ, Wilkinson E: Atlas of Tumor Pathology: Tumors of the Cervix, Vagina, and Vulva. Washington, Armed Forces Institute of Pathology, 1992, p 126.
17.
Cui S, Lespinasse P, Cracchiolo B, Sama J, Kreitzer MS, Heller DS: Large cell neuroendocrine carcinoma of the cervix associated with adenocarcinoma in situ: evidence of a common origin. Int J Gynecol Pathol 2001;20:311–312.
18.
Gilks CB, Young RH, Gersell DJ, Clement PB: Large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathologic study of 12 cases. Am J Surg Pathol 1997;21:905–914.
19.
McCluggage WG, Kennedy K, Busam KJ: An immunohistochemical study of cervical neuroendocrine carcinomas: neoplasms that are commonly TTF1 positive and which may express CK20 and p63. Am J Surg Pathol 2010;34:525–532.
20.
Sato Y, Shimamoto T, Amada S, Asada Y, Hayashi T: Large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathological study of six cases. Int J Gynecol Pathol 2003;22:226–230.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.