子宮頚部小細胞癌の１例

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  • Small cell carcinoma of the uterine cervix. A case report.

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Background: Small cell carcinoma (SMCC) is a highly lethfal lung cancer, but is relatively rare in the uterine cervix. The general rules for clinical and pathological management of uterine cervical cancer has been recently revised and clearly defines SMCC of this region, while the previous version included the entity as a subtype of undifferentiated carcinoma. We describe herein a case of uterine cervical SMCC including its histological, immunohistochemical and ultrastructural features.<BR>Case: The patient was a fifty-five year-old Japanese female who had been referred with irregular bleeding. Diagnosis of SMCC was made by cervical smear and she underwent radical hysterectomy and chemotherapy for local recurrence two months after operation, but died of the tumor fifteen months after operation.<BR>Smear cytology showed atypical neoplastic cells with a bare nuclear-like appearance and scant cytoplasm that were poorly attached or in small clusters. Chromatin pattern was granular and nucleoli were poorly defined.<BR>Histomorphologically, the tumor was a typical SMCC containing small cells with scant cytoplasm arranged in a solid or trabecular pattern. Components of squamous cell carcinoma and adenocarcinoma were also recognized. Immunohistochemically, the SMCC portion was positive for neuron-specific enolase, chromogranin and synaptophysin and the other carcinomatous portion showed immunor eactivity for carcinoembryonic antigen and epithelial membrane antigen. Electron microscopy showed neurosecretory granules with a dense core and defined border membrane.<BR>Conclusion: SMCC is a highly malignant tumor with defined clinical and morphological features, and rapid diagnosis through cytological procedures could be of therapeutic importance.

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