J Pathol Transl Med.  2015 Sep;49(5):396-402. 10.4132/jptm.2015.07.08.

Comparison of Cytologic Characteristics between Adenoid Cystic Carcinoma and Adenoid Basal Carcinoma in the Uterine Cervix

• Jeong J
• Ha SY
• Cho HY
• Chung DH
• An J

• KMID: 2381395
• DOI: http://doi.org/10.4132/jptm.2015.07.08

Abstract

BACKGROUND
Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) are rare in the uterine cervix. ACC is more aggressive than ABC, thus accurate differential diagnosis is important. In this study, we identified cytologic features useful in distinguishing these two tumors for diagnosis.
METHODS
Three cases of ACC and five cases of ABC were selected for this study. Cervicovaginal smear slides were reviewed retrospectively, and the area, circumference, major axis, and minor axis of nuclei were measured using an image analyzer.
RESULTS
ACC displayed three-dimensional clusters with a small acini pattern. ABC displayed peripheral palisading without an acini pattern. The nuclei of ACC were more irregular and angulated than those of ABC, and the former showed a coarsely granular chromatin pattern. The nucleic area, circumference, major axis, and minor axis were 18.556+/-8.665 microm2, 23.320+/-11.412 microm, 5.664+/-1.537 microm, and 4.127+/-1.107 microm in ACC and 11.017+/-4.440 microm2, 15.920+/-5.664 microm, 4.612+/-1.025 microm, and 3.088+/-0.762 microm in the cases of ABC. All measured values showed statistically significant difference (p < .001).
CONCLUSIONS
Although the nuclei of both of these tumor types were oval shaped, inferred from the ratio of minor axis to major axis (0.728 in ACC and 0.669 in ABC), the area of nuclei was approximately 1.7 times larger in ACC than in ABC. Distinguishing nucleic features, including area, morphology, and chromatin pattern, may be helpful in making a correct diagnosis.

Keyword

Adenoid cystic carcinoma; Adenoid basal carcinoma; Vaginal smears; Papanicolaou test

MeSH Terms

Adenoids*
Axis, Cervical Vertebra
Carcinoma, Adenoid Cystic*
Cervix Uteri*
Chromatin
Diagnosis
Diagnosis, Differential
Female
Papanicolaou Test
Retrospective Studies
Vaginal Smears
Chromatin

Figure

• 

  Fig. 1. Cytologic and histopathologic features of adenoid cystic carcinoma. (A) Tumor cells display three-dimensional clusters forming small acini or glandular pattern in necrotic background. (B) Some glandular structures contain opaque orangeophilic contents in the center. (C) The size of nuclei is variable. The nuclei have irregular and angulated membrane with coarsely granular chromatin pattern (arrows). (D) On histologic section, tumor nests consist of basaloid cells forming a cribriform appearance with palisading arrangement in the periphery.

• 

  Fig. 2. Cytologic and histopathologic features of adenoid basal carcinoma. (A) Clusters consist of small round basaloid cells in the necrotic background. (B) Tumor cells display three-dimensional clusters with peripheral palisading without glandular pattern. (C) The size of nuclei shows mild variation. The nucleic membrane is smooth with a finely granular chromatin pattern. (D) On histologic section, basaloid cells forming tumor nests display peripheral palisading deep in cervical stroma.

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