Abstract
Background: We previously reported that adenoma malignum of the uterine cervix expresses gastric phenotypes. Immunocytochemistry using HIK 1083, a monoclonal antibody for gastric gland mucous cell-mucin, enabled us to identify cellular clusters derived from adenoma malignum and gastric metaplasia. Furthermore, we reported that the yellowish tint of cytoplasmic mucins when the Papanicolaou stain was used was an important diagnostic clue in the identification of adenoma malignum and gastric metaplasia by cytology. We now report two cases of adenoma malignum which were detected by the two-color pattern (yellowish tint of tumor cells and pinkish tint of cervical mucous cells) in endocervical smears.
Cases: The patients were 49-year-old and 70-year-old females with no clinical symptoms. Their endocervical smears revealed clusters of mucous cells which stained yellowish with the Papanicolaou stain in screening cytology, but did not show cellular atypia. Subsequent examinations, including biopsy and MRI, suggested the presence of adenoma malignum, resulting in hysterectomy. Histologic and histochemical examination confirmed the presence of adenoma malignum with gastric metaplasia.
Conclusion: If we find mucous cellular clusters stained yellowish, even without atypia, in endocervical smears, we should encourage gynecologists to perform further examinations, such as biopsy or MRI.
