宫颈小细胞癌临床病理观察

Small cell carcinoma of cervix:a clinicopathologic analysis

目的探讨宫颈小细胞癌(SCCC)的临床病理特征、免疫组化及鉴别诊断。方法对1例SCCC进行组织形态学、免疫组化观察和文献复习。结果组织学显示为3种不同分化的细胞区域,其中大部分为形态较一致的小细胞区,细胞散在、片状或梁索状,浸润性生长;少数区域呈鳞状细胞癌和腺癌分化。免疫组化:CK和EMA(+);小细胞NSE和Syn(+)、CgA灶状(+);LCA和Vim(-)。结论SCCC是一种少见的高度恶性肿瘤,具有特征性的组织学改变,应与宫颈的小细胞鳞状细胞癌、类癌、淋巴瘤以及肺等处的转移性小细胞癌等进行鉴别。伴有鳞状细胞癌及腺癌分化的SCCC预后要比单纯小细胞癌差。

Objective To explore the histopathologic and immunohistochemical characteristics of small cell carcinoma of the cervix （SCCC） and its differential diagnosis. Methods We observed the histopathologic and immanohistochemical results in a case of mixed SCCC and the related literature was reviewed. Results Histologically, it contained three different areas of cell differentiation. The majority of the tumor was composed of cords or sheets or loose aggregates of uniform small cells; it had minor component of squamous and glandular differentiation. Immanohistochemically, the tumor cells were positive for CK, EMA, the small cells were positive for NSE, Syn, and weakly positive for CgA. Conclusion Small cell carcinoma of the cervix is a rare malignant tumor in the cervix. It has a characteristic histopathologic pattern. Differential diagnosis of it includes small cell squamous carcinoma, carcinoid, lymphoma and metastatic small cell carcinoma from the lung etc. SCCC with squamous and glandular differentiation has poorer prognosis than monomorphic type.