PMC3766596_01
Cytologic features of LCNEC. (a) Pap smear of the vagina shows atypical oval cells with scant cytoplasm and hyperchromatic coarse nuclei. Surface squamous cells showed enlarged nuclei with fine granular chromatin. (b) Pap smear of the uterine cervical tumor shows tumor cells in overlapping clusters containing oval nuclei with coarsely clumped chromatin, irregular-shaped nucleoli, and moderate granular cytoplasm.
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fig1
A speculum transvaginal examination was not able to be performed, and then a vaginal exfoliative cytology specimen had atypical cells probably malignant (Figure 1).
Pelvic MRI. (a) Sagittal fat-suppressed T1-weighted MR image after gadolinium administration showed region heterogeneously poor enhanced in cervix, vagina, and uterine corpus myometrium which were irregularly enhanced in late phase. (b) Axial fat-suppressed T1-weighted MR image after gadolinium administration showed cervical mass homogeneously enhanced in the posterior wall from the uterine cervix to the vagina.
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A pelvic MRI contrast revealed an invasive tumor in the cervix, vagina, and uterine corpus myometrium which were irregularly enhanced in late phase (Figure 2).
Histology of LCNEC with squamous cell carcinoma. (a) HE stain shows that tumor cells with trabecular patterns possess prominent nucleoi and large nuclei and a moderate amount of cytoplasm with eosinophil granule. (b) Synaptophysin is positive in the LCNEC. (c) HE stain shows squamous cancer cells without any keratin pearl. (d) The invasive tumor nests have 34bE12 positive neoplastic squamous cells.
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The mitotic activity was more than 3 mitotic figures per 10 high-power fields. The 34bE12 positive tumor cells were scattered (Figure 3).
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