Adenoma malignum of the cervix. Cytologic findings

The cytologic findings in three patients with adenoma malignum of the cervix are described. Two of them had the Peutz-Jeghers syndrome. One complained of vaginal bleeding, another of a mucoid vaginal discharge, and in the third case the tumor was discovered on routine physical examination. Cytologic material from these cases showed endocervical cells exhibiting a spectrum of atypical changes. The cells were arranged in multilayered strips, monolayered sheets and three-dimensional clusters. Individual cells ranged from cuboidal to columnar; the columnar cells typically had abundant lacy or vacuolated cytoplasm. The nuclei were round to oval and vesicular, and some of them contained prominent nucleoli. Variable numbers of mitotic figures were present. In one case the presence of numerous atypical cells was only suggestive of the diagnosis of malignancy; in the other two cases, although the majority of cells were only atypical, small numbers of frankly malignant cells were present.