原发性宫颈大细胞神经内分泌癌临床病理观察

目的 探讨原发性宫颈大细胞神经内分泌癌的临床病理特征和免疫表型.方法 对1例宫颈大细胞神经内分泌癌进行组织病理学观察和免疫组化检测,复习临床资料和相关文献.结果 本例宫颈大细胞神经内分泌癌临床表现为阴道不规则出血伴宫颈肿物.镜下见肿瘤细胞排列呈器官样结构,瘤细胞比小细胞癌大,细胞呈多角形,核大、胞质少,核染色质粗,核仁明显,核分裂活跃.局部可见坏死.免疫组化:肿瘤细胞Syn、CD56和CK8(+),CK5/6、CD10、CD15、desmin、S-100、CD20、vimentin、CD3、p53、SMA、D2-40、HMB45和TTF-1(-).结论 宫颈大细胞神经内分泌癌是一种罕见的高度恶性肿瘤,需与宫颈低分化鳞状细胞癌、低分化腺癌、类癌、不典型类癌、小细胞癌及其他肿瘤鉴别.

Primary large cell neuroendocrine carcinoma in cervix:a clincopathologic observation

Objective To study the clinical pathologic features and immunophenotype of primary large cell neuroendocrine carcinoma in the cervix.Methods One case of primary large cell neuroendocrine carcinoma in the cervix was studied by morphologic and immunohistochemical techniques,relative clinical data and literatures were reviewed.Results The patient was presented with symptoms of virginal bleedings with cervical masses.Histologically,the tumor cells were arranged in an organoid growth pattern and were larger than those of typical small cell carcinoma.The cells were large in size,polygonal in shape and low nuclear-cytoplasmic ratio;the nuclei had coarse chromatin and prominent nucleoli,and mitotic figures were frequent.Immunohistochemically,the tumor was positive for neuroendocrine markers: Syn,CD56 and epithelial marker CK8,and negative for CD10,CD15,Desmin,S-100,CD20,vimentin,CD3,P53,SMA,D2-40,HMB45 and TTF-1.Conclusion Primary large cell neuroendocrine carcinoma of the cervix is a rare highly aggressive neoplasm,and should be differentiated from poor differentiated squamous cell carcinoma,poorly differentiated adenocarcinoma,atypical carcinoid,carcinoid,small cell carcinoma and other neoplasms.