Paper # 006

Diagnostic problems in spindle-cell squamous carcinoma of the uterine cervix. Cytohistological correlation.

Ana María Puig, Marcial García Rojo, Vicente Furió(*), Rafael López.

Department of Pathology. Complejo Hospitalario de Ciudad Real. Spain.
(*) Electron Microscopy Department. Hospital Clínico Universitario San Carlos. Madrid. Spain.
Address: Complejo Hospitalario de Ciudad Real
Plaza Pío XII s/n, 13002 Ciudad Real. Spain

[Introduction] [Materials and Methods] [Results] [Pictures] [Discussion] [Bibliography]

Summary

We present the cytological and histopathological features of a spindle-cell squamous carcinoma of the uterine cervix, that has been rarely reported in this location.
: The cytological diagnosis in the vaginal and cervical smear may be difficult, due to the great morphologic variation we found in this neoplasia, that is composed of a mixture of malignant epithelial cells of an squamous appearance, spindle cells with intense nuclear atypia, and a variable number of multinucleated giant cells.
Histopathological diagnosis is readily made when more differentiated squamous component is identified, with a predominant sarcomatous appearance in the deeper areas of the tumor. Immunohistochemically, neoplastic cells express a strong positivity for both low and high weight cytokeratins in the squamous areas; and spindle-cell component, not only expresses those cytokeratins, although with variable intensity, but also vimentin. Ultrastructural study confirms the epithelial nature of the neoplasia in the spindle-cell component.

Dr. Ana Puig Rullán is pathologist and manager of the Cytology section in the Complejo Hospitalario de Ciudad Real.

The Complejo Hospitalario de Ciudad Real, comprises 700 beds, made of the Hospital "Nuestra Señora de Alarcos" and the Hospital "Nuestra Señora del Carmen".

Key Words: Fusocelular squamous carcinoma, Carcinosarcoma, Uterine cervix, Papanicolau smear, Immunohistochemistry, Electron microscopy.

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