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Cytology, immunohistochemistry and 3-dimensional reconstruction of adenoma malignum: a case report
Yoshiki Ohta1, Akira Shiokawa, Takao Suzuki
1Department of Pathology, Northern Yokohama Hospital, Showa University, Kanagawa, Japan.
Background:
Cytologic diagnosis of adenoma malignum is not easy. A case of adenoma malignum was diagnosed cytologically.
Case:
A 45-year-old woman was suspected of having adenoma malignum. Her chief complaint was a mucoid cervical discharge. Transvaginal ultrasound examination showed multiple cervical cysts, and peculiar clusters of cervical columnar cells showing a channellike structure were observed cytologically. Cytologic analysis detected tumor cells with increased euchromatin and stretched nuclear membranes with distinct eosinophilic nucleoli. Intranuclear cytoplasmic inclusion bodies and lobate or budlike nuclei were also observed. Immunohistochemically, both HIK-1083 and carcinoembryonic antigen (CEA) were positive in the histologic specimens, although only a few glands were positive for CEA. On 3-dimensional reconstruction of normal cervical tissue, glands showing similar calibers and straight lines also had a "weeping willow-shaped" growing pattern. In the adenoma malignum there were large and small glands showing a cumuliform pattern, and cystic dilation with discontinuity and fusion of glands could be seen.
Conclusion:
The nuclear findings mentioned above were thought to be diagnostic characteristics of adenoma malignum. Three-dimensional reconstruction seems to be a method that can aid in the diagnosis of adenoma malignum.
