ADENOID BASAL CARCINOMA OF THE CERVIX - A POTENTIAL PITFALL IN CERVICOVAGINAL CYTOLOGY

Adenoid basal carcinoma (ABC) of the cervix is a quite uncommon, indol ent, yet invasive neoplasm rarely identified on cervicovaginal smears. This may be due in part to sampling. Unless ABCs become ulcerated eve n vigorous brushing of the endocervical canal may not be adequate to d islodge the small, cohesive cells of this neoplasm. Fortunately, the a ssociation of ABC with squamous intraepithelial lesions (SIL) often re sults in its incidental diagnosis on follow-up cervical biopsy or endo cervical curettage. We report two cases of ABC. In case 1, a 79-yr-old white woman was diagnosed with squamous-cell carcinoma on cervicovagi nal (CV) smear. High-grade SIL, carcinoma in situ, and ABC were identi fied on subsequent cervical cone biopsy and hysterectomy. Retrospectiv e evaluation of the CV smear revealed a few aggregates of small, unifo rm cells, with hyperchromatic nuclei representing fragments of ABC. In case 2, atypical basaloid cells suspicious for ABC were recognized on the CV smear of a 67-yr-old black woman, and ABC was subsequently con firmed on cervical cone biopsy. In neither case did the intervening ce rvical biopsy reveal ABC, In addition to a review of the clinical info rmation useful in the diagnosis of ABC, the cytologic features of thes e two cases are compared with their subsequent histopathology and cont rasted with other similar lesions comprising the differential diagnosi s of small neoplastic cells found in cervicovaginal smears. (C) 1996 W iley-Liss, Inc.