We report a rare case of clear cell adenocarcinoma (CCAC) of the uterine cervix with squamous cell carcinoma in situ in a 71-year-old woman with no history of intrauterine diethylstilbestrol exposure. Cytological cervical specimens showed sheet-like peripheral rod or spike adenocarcinoma cell clusters and atypical squamous cells with abundant clear focal cytoplasm and prominent nucleoli suggesting CCAC. CCAC, while aggressive, does not necessarily mean an unfavorable prognosis in the early clinical stage. Atypical with ball-or sheet-like cells and clear cytoplasm in cervical smears should thus suggest the possibility of CCAC.
Cervicovaginal cytology has played an increasingly important role in detecting squamous and columnar epithelial lesions as columnar epithelial neoplasia of the uterine cervix has increased. We compared endocervical cell cytomorphology between smear-sampling devices. Results showed that columnar cells cluster incidence and appearance patterns differed greatly between devices. The cytobrush and Cervex brush proved more useful in detecting endocervical columnar cell abnormalities earlier than the cotton swab or the Cytopick.