SMALL-CELL CARCINOMA OF THE UTERINE CERVIX - CYTOLOGIC FINDINGS IN 13CASES

BACKGROUND. There are few reports on the cytologic features of small c ell carcinoma (SMCC) of the uterine cervix. METHODS. The clinical reco rds, histopathology, and available cervical smears from all cases of S MCC of the uterine cervix in the files of the British Columbia Cancer Agency between 1985 and 1997 were reviewed. RESULTS. Cervical smears w ere available from 11 of 13 identified cases. Six cases had a pretreat ment smear containing numerous definitely malignant cells. In the seve n cases with reported negative smears, review of the most recent smear s detected a missed high. grade squamous intraepithelial lesion in one case and rare suspicious epithelial cells in a second case. These two cases were considered to be false-negative smears on review. None of the six malignant smears were diagnosed as SMCC on cervical smears. Th ese smears were reported as malignant epithelial cells, not otherwise specified in three cases and misclassified as adenocarcinoma in three cases. These malignant smears contained cells dispersed as single cell s or arranged as loosely cohesive sheets or gland-like aggregates. Tum or cells, ranging from small to large, had extremely pleomorphic, angu lated nuclei that were hyperchromatic and showed nuclear molding and s mearing. Mitotic figures were common and karyorrhectic debris was iden tified in all cases. CONCLUSIONS. The routine cervical smear is a rela tively insensitive and nonspecific method of detecting SMCC. The speci fic diagnosis of SMCC on cervical smears is difficult. SMCC can mimic inflammatory cells, follicular cervicitis, endometrial cells, endocerv ical adenocarcinoma, squamous cell carcinoma of small cell type, non-H odgkin's lymphoma, and other unusual malignant neoplasms. The suspicio n of SMCC on a cervical smear should prompt an urgent biopsy to establ ish the diagnosis and initiate prompt treatment. Cancer (Cancer Cytopa thol) 1998;84:281-8. (C) 1998 American Cancer Society.