Cytologic diagnosis of small-cell neuroendocrine carcinoma of the uterine cervix

Abstract

Small-cell neuroendocrine carcinoma (SCNC) of the uterine cervix is a rare disease, but its prognosis is grave. The correct cytodiagnosis is, therefore, required especially for differentiation from other types of small-cell tumors.
We encountered 1917 cases of invasive cervical carcinoma in the period from 1977 throughout 1993. Six (0.31%) of these cases were definitively diagnosed as having SCNC from cytological findings including hematoxylin-eosin staining, immunohistochemistry and electron microscopic observation.
Analyzing the cytological findings obtained in these six cases in a retrospective manner, we identified the following cytological characteristics of SCNC: 1) Presence of abundant cell necrosis and few inflammatory cells, 2) dispersion of cancer cells, some of which formed loosely-arranged clusters (no consistent direction of cell arrangement), 3) nuclei were exposed and untangled in some of these clusters, 4) round to oval nuclear forms, scanty cytoplasm, high nuclear/cytoplasm ratio, finely granular chromatin and inconspicuous nucleoli, and 5) occasional presence of components of squamous cell carcinoma and/or adenocarcinoma.
It is possible to diagnose SCNC, if all of these characteristics are confirmed.