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Habara K, Nishikori A, Kiyama J, Nakashima M, Koda M, Sasaki K, Sakashita T, Tanaka N, Yonehara S. A case of coexistent poorly differentiated adenosquamous carcinoma (glassy cell carcinoma), usual-type adenocarcinoma, and squamous cell carcinoma in situ of the cervix. Med Mol Morphol 2023; 56:217-224. [PMID: 37129713 PMCID: PMC10415468 DOI: 10.1007/s00795-023-00354-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
Poorly differentiated adenosquamous carcinoma (glassy cell carcinoma) of the cervix is extremely rare, accounting for 1-2% of all cervical cancers. Herein, we report a case with coexistent poorly differentiated adenosquamous carcinoma (glassy cell carcinoma), "usual-type" adenocarcinoma, and squamous cell carcinoma in situ of the cervix. A female patient in her 60 s was referred to our hospital and diagnosed with poorly differentiated adenosquamous carcinoma based on cervical cytology and biopsy. The tumor was classified as clinical stage IB1 cervical cancer following magnetic resonance imaging; radical hysterectomy was performed. Histopathological examination revealed poorly differentiated adenosquamous carcinoma (glassy cell carcinoma), usual-type adenocarcinoma, and squamous cell carcinoma in situ, all coexisting. All carcinoma regions showed identical sizes to high-risk human papillomavirus (HPV) in fragment analysis. The patient is currently alive, without evidence of recurrence, 31 months post surgery. In this case, three different carcinomas coexisted. Fragment analysis of the patient's HPV status suggested that all carcinomas were related to an infection with the same high-risk HPV type. To determine the precise mechanism of tumor development, i.e., whether the tumors were of the mixed or collision type, further studies are needed, including clonal analysis for the loss of heterozygosity pattern.
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Affiliation(s)
- Kouki Habara
- Department of Pathology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
| | - Asami Nishikori
- Department of Molecular Hematopathology, Faculty of Health Sciences, Okayama University School of Medicine, 2-5-1 Shikata, Kita-Ku, Okayama, Japan
| | - Jin Kiyama
- Department of Medical Technology, Okayama University Hospital, 2-5-1 Shikata, Kita-ku, Okayama, Japan
| | - Manami Nakashima
- Department of Pathology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
| | - Masanori Koda
- Department of Pathology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
| | - Kenji Sasaki
- Department of Pathology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
| | - Tomohisa Sakashita
- Department of Obstetrics and Gynecology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
| | - Norifumi Tanaka
- Department of Obstetrics and Gynecology, National Hospital Organization East Hiroshima Medical Center, 513 Jike, Saijo, Higashihiroshima, Hiroshima, Japan
| | - Shuji Yonehara
- Department of Pathology, Japan Agricultural Cooperatives Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan
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Jung YY, Nahm JH, Kim HS. Cytomorphological characteristics of glassy cell carcinoma of the uterine cervix: histopathological correlation and human papillomavirus genotyping. Oncotarget 2018; 7:74152-74161. [PMID: 27708230 PMCID: PMC5342042 DOI: 10.18632/oncotarget.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/17/2016] [Indexed: 11/25/2022] Open
Abstract
A retrospective analysis was performed to describe the cytomorphological and histopathological findings and human papillomavirus (HPV) genotypes for glassy cell carcinoma (GCC) of the uterine cervix. Five cases of cervical GCC, in which the glassy cell features constituted at least 95% of the specimen, were included. Four patients had stage IIB GCCs and one had stage IIIB GCC. All patients underwent concurrent chemoradiation therapy. Based on pretreatment cytology, only 1 of the 5 cases was correctly diagnosed as GCC. The remaining cases were diagnosed as carcinoma of undetermined type, adenocarcinoma, poorly differentiated carcinoma, or unsatisfactory for evaluation. Cytological specimens had moderate cellularity and contained small clusters of tumor cells admixed with amphophilic, granular tumor diathesis. The tumor cells possessed large, round to oval nuclei and abundant, granular, ground-glass cytoplasm. The nuclei exhibited prominent eosinophilic nucleoli. The cytoplasm displayed sharp margins and molding, resulting in “intercellular windows” between neighboring attached cells. HPV genotyping revealed that high-risk HPV types 18, 16, and 31 were detected in 3, 1, and 1 cases, respectively. Consistent with this finding, all cases exhibited block p16 positivity, confirming the association of HPV infection with GCC. In conclusion, a distinct cytoplasmic margin, the characteristic histopathological feature of GCC, was observed in liquid-based cytological preparations. We suggest that sharp cytoplasmic outlines with molding and intercellular windows are characteristic cytomorphological features of GCC. Detection of high-risk HPV in all cases strongly supported the notion that high-risk HPV is involved in the pathogenesis of GCC.
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Affiliation(s)
- Yoon Yang Jung
- Department of Pathology, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Republic of Korea
| | - Ji Hae Nahm
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yoon N, Kim JY, Kim HS. Clinical outcomes of advanced-stage glassy cell carcinoma of the uterine cervix: a need for reappraisal. Oncotarget 2018; 7:78448-78454. [PMID: 27793022 PMCID: PMC5346652 DOI: 10.18632/oncotarget.12905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022] Open
Abstract
We performed a retrospective analysis of the clinical features and patient outcomes for advanced-stage glassy cell carcinoma of the uterine cervix. The study was restricted to cases in which the glassy cell features constituted at least 95% of the biopsied specimen. During the study period, 675 patients were diagnosed with primary cervical carcinoma. Five (0.7%) of the 675 patients had cervical glassy cell carcinoma; of these, three were premenopausal, and two were postmenopausal. Abnormal vaginal bleeding was the most frequent presenting symptom. Glassy cell carcinoma presented as a fungating, exophytic, or infiltrative mass. The greatest tumor dimension ranged from 3 to 9 cm. All patients had parametrial extension. Four patients had stage IIB tumors, and one had a stage IIIB tumor. All patients received concurrent chemoradiation therapy. The patient with a stage IIIB tumor died of hypovolemic shock caused by upper gastrointestinal bleeding during radiation therapy. Three patients with stage IIB tumors survived for more than 8 years without tumor recurrence or metastasis. One of these three patients died of pelvic recurrence 10 years after the initial diagnosis. Cervical glassy cell carcinoma has traditionally been considered an aggressive, highly malignant tumor with poor prognosis, but our data suggest that patient survival is not significantly decreased compared with other histological types of cervical carcinoma. It will be necessary to analyze patient outcomes using a larger number of cervical glassy cell carcinoma cases to confirm our findings.
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Affiliation(s)
- Nara Yoon
- Department of Pathology, The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, Republic of Korea
| | - Ji-Ye Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Zolciak-Siwinska A, Jonska-Gmyrek J. Glassy cell carcinoma of the cervix: a literature review. Eur J Obstet Gynecol Reprod Biol 2014; 179:232-5. [PMID: 24792540 DOI: 10.1016/j.ejogrb.2014.03.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 02/04/2014] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Abstract
Glassy cell carcinoma (GCC) is a histologically aggressive subtype of cervical cancer with rapid growth and early metastases. The prognosis for patients with GCC is poor. This article reviews the literature pertinent to the epidemiology, cytology, pathology, immunohistochemistry, treatment and prognosis of GCC. MEDLINE (PubMed) was searched for all articles or abstracts on patients diagnosed with GCC published (in English) since the original definition by Glucksmann and Cherry, Cancer 1956;9:971. Accurate diagnosis of GCC enables implementation of the correct treatment strategy. Early-stage GCC should be treated with hysterectomy and pelvic lymph node dissection, with adjuvant radiochemotherapy if at least one intermediate or high risk factor for cervical cancer is present. Advanced GCC should be treated with neoadjuvant radiochemotherapy or chemotherapy with the aim of making the disease operable. There is a need for retrospective evaluation of GCC treatment from several centres to explore knowledge about this rare entity. Future studies should explore the role of targeted therapies and the most efficient chemotherapy regimen for the management of GCC.
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Affiliation(s)
- A Zolciak-Siwinska
- Department of Brachytherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
| | - J Jonska-Gmyrek
- Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
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Khalbuss WE, Pantanowitz L, Monaco SE. Cytomorphology of unusual primary tumors in the Pap test. Cytojournal 2013; 10:17. [PMID: 24082913 PMCID: PMC3779403 DOI: 10.4103/1742-6413.117356] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/02/2013] [Indexed: 01/10/2023] Open
Abstract
Rare entities in the Pap test, which include neoplastic and non-neoplastic conditions, pose challenges due to the infrequent occurrence of many of these entities in the daily practice of cytology. Furthermore, these conditions give rise to important diagnostic pitfalls to be aware of in the Pap test. For example, cases with adenoma malignum (AM) have been called benign. Recognition of these conditions can help correctly interpret Pap tests as abnormal and thereby ensure that patients get appropriately diagnosed. In this paper, we illustrate and discuss selected uncommon primary neoplastic lesions of the cervix and the vagina that may be seen in Pap test, with a focus on cytomorphology, differential diagnosis and the role of possible ancillary studies. These cases include high-grade squamous intraepithelial lesion cells with small cell morphology; small cell carcinoma; large neuroendocrine carcinoma; glassy cell carcinoma; AM; malignant mixed Müllerian tumor; clear cell carcinoma and primary malignant melanoma. Recognition of these rare variants/neoplasms is important so that involved Pap tests are not diagnosed as benign and that patients with these conditions get additional follow-up.
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Affiliation(s)
- Walid E. Khalbuss
- Address: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Liron Pantanowitz
- Address: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sara E. Monaco
- Address: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Deshpande A, Kotwal MN, Bobhate SK. Glassy cell carcinoma of the uterine cervix a rare histology. Report of three cases with a review of the literature. Indian J Cancer 2004. [DOI: 10.4103/0019-509x.12353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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