Small‐cell neuroendocrine carcinoma in directly sampled endometrial cytology: A monocentric retrospective study of six cases

Ebisu, Yusuke; Ishida, Mitsuaki; Okano, Kimiaki; Sandoh, Kaori; Mizokami, Tomomi; Kita, Mihori; Okada, Hidetaka; Tsuta, Koji

doi:10.1002/dc.24298

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Like their counterparts in the cervix and ovary, neuroendocrine carcinomas of the endometrium can be admixed with adenocarcinoma 27,29 . Because the cytologic features of UC/DC and small cell neuroendocrine carcinoma can show overlap (cells with high nuclear‐to‐cytoplasmic ratios, inconspicuous nucleoli, nuclear molding, and numerous apoptotic bodies and mitotic figures associated with a variably inflammatory/necrotic background), immunohistochemistry for neuroendocrine markers is valuable in distinguishing these entities 30 . The percentage of tumor cells expressing at least one neuroendocrine marker (eg, synaptophysin, chromogranin) in UC should be limited to <10% 2,8,27 …”

Section: Discussionmentioning

confidence: 99%

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Akbari

Wang

Soslow

et al. 2020

Cancer Cytopathology

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Background Undifferentiated carcinoma (UC) is a rare, aggressive subtype of endometrial carcinoma. Dedifferentiated carcinomas (DCs) are UCs associated with a component of well differentiated endometrioid carcinoma. The authors sought to describe the morphologic features of UCs and DCs in cytologic specimens. Methods Cytologic specimens from 23 women (aged 46‐86 years; median age, 59 years) were reviewed, including cervicovaginal specimens (n = 7), peritoneal washings (n = 5), touch preparations of core biopsies from various sites (n = 5), fine‐needle biopsies of lymph nodes (n = 3), ascitic fluid (n = 1), pleural fluid (n = 1), and intrauterine fluid (n = 1). Results There were 10 UCs (43%) and 13 DCs (57%). Tumor cells were arranged as single cells (9 UCs, 90%; 12 DCs, 92%) and 3‐dimensional groups (8 UCs, 80%; 11 DCs, 85%). Most cases showed high nuclear‐to‐cytoplasmic ratios. Nuclear molding was observed in 3 UCs (30%) and in 5 DCs (38%). Nuclear chromatin was often coarsely granular 6 UCs, 60%; 9 DCs, 69%). Nucleoli were inconspicuous in some cases (6 UCs, 60%; 8 DCs, 62%) but were appreciable in others. Necrosis was observed in 5 UCs (50%) and in 5 DCs (38%). Most cases exhibited clean backgrounds, and a few showed acute inflammation. Comparison of the cytologic features of UCs and DCs did not reveal any statistically significant differences. Conclusions UCs and DCs have a spectrum of cytomorphologic appearances that are not pathognomonic, but the presence of some of these (relatively uniform population of predominantly singly dispersed cells with high nuclear‐to‐cytoplasmic ratios and variably conspicuous nucleoli) should prompt consideration of UC and DC in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Akbari

Wang

Soslow

et al. 2020

Cancer Cytopathology

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“…The diagnosis of small-cell NEC was independently confirmed by two diagnostic pathologists. The majority of the patients evaluated in the present study were also included in our previous study on the cytological characteristics of endometrial small-cell NEC ( 14 ). Patients who had been administered preoperative chemotherapy were excluded.…”

Section: Methodsmentioning

confidence: 99%

Immunohistochemical analysis of SOX2 expression in small‑cell neuroendocrine carcinoma of the endometrium

et al. 2020

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Small-cell neuroendocrine carcinoma (NEC) of the endometrium is an extremely rare and highly aggressive carcinoma. Sex-determining region Y-box 2 (SOX2) is a master transcription factor regulating the self-renewal, maintenance of stem cell properties and pluripotency of embryonic stem cells, and recent studies revealed that SOX2 plays important roles in cancer growth and progression in several types of carcinomas, including small-cell neuroendocrine carcinoma (NEC) of the lung and oesophagus. Few studies to date have analysed the association between SOX2 and endometrioid carcinoma, whereas the expression of SOX2 in small-cell NEC of the endometrium has not been investigated. The aim of the present study was to analyse the expression status of SOX2, p16 and paired-box gene (PAX) 8, a useful Müllerian marker, in endometrial small-cell NEC. A total of 4 patients with small-cell NEC of the endometrium were enrolled (median age, 70 years). Immunohistochemical studies revealed SOX2 expression in 3 patients and p16 expression in all patients. No patients exhibited positive immunoreactivity for PAX8. SOX2 expression has been reported to be associated with the pathogenesis of small-cell NEC of the oesophagus. Therefore, the results of the present study indicated that SOX2 expression plays an important role in the development of small-cell NEC of the endometrium and the oesophagus. Moreover, expression of p16 and loss of PAX8 do not indicate the origin of small-cell NEC of the endometrium.

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“…Few reports have described small‐cell neuroendocrine carcinoma (SCNEC) in the female genital tract 1,2 . While cervical SCNEC comprises 2–5% of all cervical cancers, 3–5 adenocarcinoma and/or squamous cell carcinoma components may be presented 6–9 .…”

Section: Figurementioning

confidence: 99%

“…adenocarcinoma, cervix, high-grade squamous intraepithelial lesion, small-cell neuroendocrine carcinoma Few reports have described small-cell neuroendocrine carcinoma (SCNEC) in the female genital tract. 1,2 While cervical SCNEC comprises 2-5% of all cervical cancers, [3][4][5] adenocarcinoma and/or squamous cell carcinoma components may be presented. [6][7][8][9] Here, we describe a case of cervical SCNEC accompanied by adenocarcinoma and high-grade squamous intraepithelial lesion (HSIL).…”

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Small‐cell neuroendocrine carcinoma of the cervix accompanied by adenocarcinoma and high‐grade squamous intraepithelial lesion

Okabe

Ishida

Noda

et al. 2022

Diagnostic Cytopathology

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Few cytological reports have described small‐cell neuroendocrine carcinoma (SCNEC) in the female genital tract. In the present study, we describe a cytological case of SCNEC accompanied by adenocarcinoma, as well as high‐grade squamous intraepithelial lesion (HSIL). A Japanese woman (42 years old) presented with abnormal genital bleeding. A conventional Papanicolaou smear revealed an inflammatory condition with three neoplastic components: SCNEC as irregular aggregates of neoplastic small round cells with nuclear molding and granular chromatin; adenocarcinoma as columnar cell clusters with peripherally located large nuclei, and HSIL as sheets or clusters of dysplastic basal‐type squamous cells with irregular hyperchromatic nuclei. Accordingly, a cytodiagnosis of SCNEC with adenocarcinoma and HSIL was made. Owing to the rarity of cervical SCNEC, cytological diagnosis may be difficult. Due to its aggressive clinical behavior, the presence of an SCNEC component should be verified in any cytodiagnosis of adenocarcinoma or HSIL.

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Small‐cell neuroendocrine carcinoma in directly sampled endometrial cytology: A monocentric retrospective study of six cases

Cited by 5 publications

References 10 publications

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Immunohistochemical analysis of SOX2 expression in small‑cell neuroendocrine carcinoma of the endometrium

Small‐cell neuroendocrine carcinoma of the cervix accompanied by adenocarcinoma and high‐grade squamous intraepithelial lesion

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