1984 Volume 23 Issue 3 Pages 461-466
A 75-year old female was admitted to Kawasaki Medical School Hospital for a possible endometrial cancer suspected on account of genital bleeding. Physical examination on admission revealed no abnormalities except for palish skin. External genitalia and vagina were unremarkable. Uterus was normal in size with anterior flexion. The vaginal portion of the cervix was markedly reddish for its entire circumference. A high density mass measurring 10×10cm was detected posterior to the urinary bladder with CT scanning. Endometrial stromal sarcoma was diagnosed on the specimens obtained from the cervical canal by both cytological and histological examinations. She was discharged after a good response to combined chemo-and radiotherapy. She was, however, readmitted because of ascites. Malignant cells were noted in the aspirate. Her general condition deteriorated and died 6 months after the diagnosis was made. Autopsy was not performed.
Cytological examination of the material scraped from the cervix disclosed small tumor cells scattered among small numbers of neutrophils and lymphocytes in a hemorrhagic background. The tumor cells had oval-shaped nuclei and scanty cytoplasm with indistinct cytoplasmic outlines. Comet cells with nuclear tapering at one end were seen occasionally. Nuclear chromatin was fine with one to two small but distinct nucleoli. Similar findings were observed on the imprints of the biopsy material. These small ovoid cells were seen forming loosely cohesive aggregates in the ascites. Lightmicroscopically, the lesion consisted of sheets of small cells resembling undifferentiated stromal cells of the endometrium. There was no specific structure discernible. Over 20/10 HPF mitotic figures were encountered.
