PMC3882930_01
Macroscopic findings of the vaginal tumor. A) Before radiotherapy, a dark red, fragile, hemorrhagic mass without continuity with the uterine cervix was recognized on the vaginal wall. B) After radiotherapy, the tumor contracted markedly and was scarred (circled in red).
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Colposcopy detected a fragile, hemorrhagic tumor-like mass mainly on the posterior vaginal wall (Figure 1A). Colposcopy after radiotherapy detected only a trace-like elevation on the vaginal wall (Figure 1B).
Histopathological findings of the vaginal tumor. A indicates alveolar solid growth of nuclear chromatin-rich atypical cells with a high N/C ratio, where a rosettelike structure was partially recognized. Immunostaining was positive for chromogranin A (B) and synaptophysin (C).
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Biopsy tissue diagnosis of the vaginal tumor indicated alveolar solid growth of nuclear chromatin-rich atypical cells with a high N/C ratio and a partially recognized rosette-like structure on the background of the necrotic tissue, suggesting a differentiated neuroendocrine system (Figure 2A). A and synaptophysin (Figure 2B, C). According to the above, primary small cell carcinoma of the vagina was diagnosed.
Imaging findings. A) MRI detected a tumor in the vaginal wall (circled). B) PET-CT. Positive accumulation of FDG was recognized in the site where MRI had detected the tumor (circled). C) No abnormal accumulation was recognized in any organ including the lung fields other than the vaginal wall.
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MRI findings detected irregularity in the posterior vaginal wall (Figure 3A). PET-CT detected positive accumulation in the lesion in the superior vagina, which had been indicated by MRI (Figure 3B). No abnormal accumulation was recognized in any other organ including the lung fields (Figure 3C).