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Aims-To examine neuroendocrine differentiation, as shown by chromogranin A (CGA) expression, in cervical carcinomas. Methods-Sixty seven cervical carcinomas were studied and were classified as adenocarcinomas, adenosquamous carcinomas or squamous cell carcinomas based on the assessment of haematoxylin and eosin staining and stains for mucin. Where features of glandular differentiation were identified, sections were also stained for evidence of intestinal type mucin. CGA immunostaminig was done and the results were graded on a three point scale: 0, + (1-5% of cells positive) and + + (>5% of cells positive). These findings were then analysed with respect to lymph node status, tumour differentiation and clinical outcome. Results-There were 32 adenocarcinomas, 18 adenosquamous carcinomas and 17 squamous cell carcinomas. Positive staining was seen in 14 (20X9%) cases, of which four were strongly positive. All but one case were either adenocarcinomas or adenosquamous carcinomas. There was a trend for CGA positivity to be related to intestinal differentiation but this failed to reach statistical significance. No correlation could be demonstrated between CGA staining and lymph node status, tumour differentiation and clinical outcome. Conclusions-Neuroendocrine differentiation is common in cervical carcinomas where there is evidence of glandular differentiation. Whilst the numbers in this study are relatively small, the presence of neuroendocrine cells in otherwise typical carcinomas does not seem to have any association with clinical behaviour. Neuroendocrine differentiation in carcinomas of the cervix is unusual, but is well recognised. It is seen in neoplasms ranging from well differentiated carcinoid tumours to poorly differentiated small cell carcinomas. These tumours morphologically resemble their counterparts at other sites ofthe body-for example, in the gastrointestinal tract and lung. Isolated neuroendocrine cells are, however, also present in the common types of cervical carcinoma, but are not evident on routine haematoxylin and eosin preparations.'Sixty seven cases of cervical carcinoma were studied to elucidate: (1) the prevalence of Cases showing features of glandular differentiation were also stained with PB/KOH/PAS to identify the presence ofintestinal type mucin.3Immunostaining was performed using a standard avidin biotin complex (Dako, High Wycombe, UK) alkaline phosphatase technique. A rabbit antihuman monoclonal antibody to chromogranin A (Dako) was supplied at a concentration of 3 g/l in a solvent of 0O1 NaCl and 15 mM NaNz and was used at a dilution of 1 in 50 in Tris buffered saline.Incubation was performed for 50 minutes at room temperature. Positive and negative controls were used throughout.The presence of diffuse cytoplasmic staining was assessed. Positivity was graded on a three point scale: 0, + and + + for no positivity, positivity in 1-5% cells and positivity in >5% of cells, respectively. The presence or absence of cytoplasmic staining in the adjacent normal endocervical columnar an...

Inflammatory fibroid polyp (IFP) of the gastrointestinal tract is a type of inflammatory pseudotumor or inflammatory myofibroblastic tumor that occurs most commonly in the stomach but also in the small and large bowel. Small-bowel IFP usually presents with intussusception. The purpose of the current study is to describe cytological features of this lesion with differential diagnoses since pathologists may be called on to render a diagnosis on fine-needle aspiration. Two cases of IFP are described with diagnostic features on imprint smears. Both were middle-aged obese women with a history of prior intra-abdominal surgical procedures who presented with signs of intestinal obstruction and were found to have a tumor causing intussusception. At intraoperative consult, scrape cytology specimens showed cellular smears with a heterogeneous population of myofibroblasts, inflammatory cells and vessels. The features together with clinical history are sufficient to suggest the diagnosis. IFP is a lesion with a characteristic morphology. The differential diagnosis includes several other lesions, hence triage of cytological specimen for culture, electron microscopy, and immunohistochemistry is important in facilitating a correct diagnosis. Although a surgical procedure may still be necessary once a diagnosis of IFP is made, treatment may be tailored for a less aggressive process.