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Advisor(s)
Abstract(s)
O presente estudo reporta o caso de uma mulher de 63 anos da qual a única informação clínica era a suspeita de um sarcoma da cérvix. Simultaneamente à colpocitologia, foram enviadas biópsias do colo e do endométrio para diagnóstico. A visualização da amostra citológica revelou vários agregados de número variável de células monótonas, com tamanho pequeno, formato redondo e citoplasma escasso, num fundo com diátese. Os núcleos apresentavam moldagem, hipercromasia, cromatina “sal-e-pimenta” e ausência de nucléolos. O aspeto microscópico das biópsias foi concordante com os achados citológicos, tendo sido igualmente identificados focos glanduliformes com características atípicas. A neoplasia mostrou expressão imunohistoquímica dos antigénios enolase neurónio-específica (neuron specific enolase, NSE), sinaptofisina e citoqueratina (clones AE1/AE3), e uma elevada atividade proliferativa demonstrada pela imunorreactividade para o marcador nuclear Ki67/Mib1. Os achados citológicos, histológicos e imunohistoquímicos foram consistentes com o diagnóstico de carcinoma neuroendócrino de pequenas células. Dos tumores cervicais, esta neoplasia maligna é das mais raras, mostrando um comportamento muito agressivo, com prognóstico muito pobre, em que as terapêuticas existentes são pouco consensuais quanto à sua eficácia. A sua etiologia ainda é estudada, podendo estar relacionada com a infeção pelo Vírus do Papiloma Humano.
ABSTRACT - The present study shows the case of a 62 years old woman, whose only clinical data was a suspected cervical sarcoma. A liquid-based cytology and biopsies from the cervix and the endometrium were done and sent for diagnostic laboratory. The cytology showed numerous groups of a variable number of monotonous, small and round cells, having scarce cytoplasm in a diathesis background. The nuclei featured molding, hyperchromasia, “salt-and-pepper” chromatin and no nucleoli. Similar observations could be found with the biopsies, where atypical gland-like groups were also detected. This neoplasia showed positive immunostaining for neuron specific enolase, synaptophysin and cytokeratin (AE1/AE3 clone antibodies), and a proliferative activity demonstrated by the nuclear marker Ki67/Mib1 immunorreactivity. The cytological, histological and imunohistochemical findings were consistent with the diagnosis of a small cell neuroendocrine carcinoma. Of all the cervical tumors, this sort of malignancy is one of the rarest and has a very aggressive behavior, with poor prognosis and without effective treatment. Its cause may be related to the Human Papillomavirus infection, but this still remains in study.
ABSTRACT - The present study shows the case of a 62 years old woman, whose only clinical data was a suspected cervical sarcoma. A liquid-based cytology and biopsies from the cervix and the endometrium were done and sent for diagnostic laboratory. The cytology showed numerous groups of a variable number of monotonous, small and round cells, having scarce cytoplasm in a diathesis background. The nuclei featured molding, hyperchromasia, “salt-and-pepper” chromatin and no nucleoli. Similar observations could be found with the biopsies, where atypical gland-like groups were also detected. This neoplasia showed positive immunostaining for neuron specific enolase, synaptophysin and cytokeratin (AE1/AE3 clone antibodies), and a proliferative activity demonstrated by the nuclear marker Ki67/Mib1 immunorreactivity. The cytological, histological and imunohistochemical findings were consistent with the diagnosis of a small cell neuroendocrine carcinoma. Of all the cervical tumors, this sort of malignancy is one of the rarest and has a very aggressive behavior, with poor prognosis and without effective treatment. Its cause may be related to the Human Papillomavirus infection, but this still remains in study.
Description
Keywords
Anatomia patológica Colpocitologia Carcinoma neuroendócrino Colpocytology Neuroendocrine carcinoma
Pedagogical Context
Citation
Machado BG, Luís A, Mendonça P. Carcinoma neuroendócrino de pequenas células: um estudo de caso em citopatologia ginecológica. Citotech Online. 2015;1(1):1-7.