Cytopathological observations in a 27-year-old female patient with endometrioid adenocarcinoma arising in the lower uterine segment of the uterus

The determination of the malignancy of an endometrioid adenocarcinoma arisi ng in the lower uterine segment (LUS) is difficult because of the high degr ee of differentiation of adenocarcinoma. The cytopathological and immunohis tochemical features of endometrioid adenocarcinoma arising in the LUS of a young adult female are presented. The preoperative cytopathological examina tion of a 27-yr-old female could not enable an accurate diagnosis of malign ancy. Hysterectomy specimens revealed the presence of all endometrioid-type adenocarcinoma with minimal atypia and myometrial invasion, which was loca ted in the LUS. This tumor was consistent with a histological diagnosis of endometrioid minimal-deviation adenocarcinoma (MDA). Immunohistochemically, the tumor's glands were p53-, proliferating cell nuclear antigen-, and car cinoembryonic antigen-positive, and estrogen receptor-, progesterone recept or-, and vimentin-negative. The cytological and surgical specimens showed a remarkable association of squamous metaplasia, Although cytopathological d ifficulties in determining malignancy of MDA endometrioid adenocarcinoma ar ising in the LUS are well-known, the following features worth noting includ e: 1) squamous metaplasia on cytological and histological slides; 2) epithe lial cells incorporating polymorphic nuclear neutrophils on cytological sli des; and 3) positive immunohistochemistry of p53 protein. Diagn. Cytopathol . 1999,21:117-121. (C) 1999 Wiley-Liss, Inc.