Classy cell carcinoma of the uterine cervix - Report of a case with cytohistologic and immunohistochemical study

BACKGROUND: Glassy cell carcinomas of the uterine cervix are poorly differe ntiated carcinomas composed of cells with a large, round to oval nucleus co ntaining one or multiple prominent nucleoli, finely vacuolated cosinophilic to amphophilic cytoplasm and distinct cell borders. These cells occur irt sheets and chords, with fibrovascular septae presenting a mixed inflammator y infiltrate. This neoplasm has a poor response to radiotherapy and a worse prognosis that the usual types of adenocarcinoma and squamous cell carcino ma. There are few reports oil the cytologic and histopathologic features of this neoplasm. CASE: A 56-year-old woman presented with a large, exophytic cervical tumor. Exfoliative cytology showed clusters of cells and single cells with large, round to oval nuclei, with one or multiple nucleoli and moderate to large, finely granulated cytoplasm with distinct cell borders The background of t he smears had a polymorphous inflammatory infiltrate, necrotic debris and p roteinaceous material. A high mitotic rate was observed, as were rare bizar re and atypical multinucleated cells. There tons no evidence of koilocytes. These findings were highly suggestive of glassy cell carcinoma and were co nfirmed by the histologic and immunocytochemical findings, with positivity for cytokeratin (MNF116), vimentin and carcinoembryonic antigen and negativ ity for HMB-45. CONCLUSION: Glassy cell carcinoma of the cervix presents a cytologic pictur e that can be highly suggestive of the diagnosis in typical cases; however, in difficult cases ancillary techniques, such as immunocytochemistry, as w ell as histologic findings might confirm the diagnosis.