Morphologic features of gastric-type cervical adenocarcinoma in small surgical and cytology specimens Journal Article

   

Authors:	Turashvili, G.; Morency, E. G.; Kracun, M.; DeLair, D. F.; Chiang, S.; Soslow, R. A.; Park, K. J.; Murali, R.
Article Title:	Morphologic features of gastric-type cervical adenocarcinoma in small surgical and cytology specimens
Abstract:	Gastric-type cervical adenocarcinoma (GCA) is a human papillomavirus-unassociated, aggressive, chemorefractory tumor. Well-differentiated examples may exhibit bland morphologic appearances, which could potentially lead to misdiagnosis, particularly in limited material. We sought to characterize the morphologic features of GCA in surgical biopsy and cytology specimens. We identified patients with histologic diagnoses of GCA or minimal-deviation adenocarcinoma between 2004 and 2017. Available slides from biopsy, curettage, and cytology specimens were reviewed. Fifty-nine specimens (37 histology, 22 cytology) were reviewed from 23 patients, including histology specimens alone from 6 patients, cytology specimens alone from 4 patients, and both types of specimen from 13 patients. The median patient age was 52 yr (range, 29-83 yr). Biopsies showed well-to-moderately differentiated adenocarcinomas composed of cells with pale or foamy cytoplasm and well-defined cytoplasmic borders. Nuclei exhibited mild-to-moderate pleomorphism with small nucleoli. The diagnosis was challenging in a minority of biopsies in which neoplastic glandular epithelium was scant, fragmented, and/or well differentiated. Cytology slides showed single and crowded clusters of tumor cells with pale, foamy, and/or vacuolated cytoplasm and well-defined cytoplasmic borders. Nuclei were moderately pleomorphic, round to oval with one or more nucleoli. Of 20 submitted biopsies, GCA was suspected by the submitting pathologist in only 5 (25%) cases. Awareness of the morphologic features and use of confirmatory ancillary studies (eg, immunohistochemistry for markers of gastric differentiation and human papillomavirus testing) will allow accurate diagnosis of these aggressive tumors in biopsy and cytology specimens. © 2018 by the International Society of Gynecological Pathologists.
Keywords:	histopathology; cytology; biopsy; cervix; adenoma malignum; gastric-type adenocarcinoma; minimal-deviation adenocarcinoma
Journal Title:	International Journal of Gynecological Pathology
Volume:	38
Issue:	3
ISSN:	0277-1691
Publisher:	Lippincott Williams & Wilkins
Date Published:	2019-05-01
Start Page:	263
End Page:	275
Language:	English
DOI:	10.1097/pgp.0000000000000519
PUBMED:	29750702
PROVIDER:	scopus
PMCID:	PMC6230321
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064404807&doi=10.1097%2fPGP.0000000000000519&partnerID=40&md5=006c6480f32e1590f1671424dfa9cfa0
Notes:	Article -- Export Date: 1 May 2019 -- Source: Scopus

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