Cytologic and cytochemical features of adenoma malignum of the uterine cervix

BACKGROUND. We previously reported that adenoma malignum (the mucinous type of minimal deviation adenocarcinoma [mucinous MDA]) of the uterine cervix expresses gastric phenotypes. The application of immunocytochemistry using HIK1083, a monoclonal antibody for gastric gland mucous cell mucin, enabled us to identify cellular clusters derived not only from typical lesions of mucinous MDA and less well differentiated lesions but also from gastric met aplasia. In this study, we tried to clarify the cellular features of such c lusters in cervical and endometrial smears. METHODS. Twelve cases of mucinous MDA were studied. Papanicolaou stain and immunostaining with HIK1083 were performed on histologic and cytologic slid es, including cervical and endometrial smears, decolorized smear slides, im print slides of the tumors, and imprint slides of normal endocervical and g astric mucosa. RESULTS. Cellular clusters derived from metaplastic lesions, typical lesion s, and less well differentiated lesions were found in 9, 4, and 2 cases, re spectively. The cellular clusters derived from the metaplastic lesions lack ed atypia but resembled those from gastric mucosa. Those derived from the t ypical lesions showed slight atypia. The cytoplasmic mucins of these cellul ar clusters, which were positive for HIK1083, were stained yellowish-orange by Papanicolaou stain, whereas those of normal endocervical cells were neg ative for HIK1083 and were stained pinkish by Papanicolaou stain. CONCLUSIONS, Yellowish-orange staining of cytoplasmic mucins by the Papanic olaou method is an important diagnostic clue aiding identification of mucin ous MDA and related lesions by cytology. Moreover, immunostaining with HIK1 083 is a useful tool in the diagnosis of these lesions by cytology as well as by histology. Cancer (Cancer Cytopathol) 1999;87:245-53. (C) 1999 Americ an Cancer Society.