Small cell endocrine carcinoma is a rare neoplasia and has a bad prognosis. This is a well known neoplasia in the lung called "Oat Cell" carcinoma. This lesion can also be found in the skin, gastrointestinal tract, cervix and pancreas.

In about 50% of the cases the normal glandular epithelium may contain a few isolated neuroendocrine cells, demonstrated by argyrophilic and argentaffin reactions. They are part of the APUD (Amine Precursor Uptake Decarboxylation) system and also have secretory granules stained by Grimelius staining.

There is often a great number of tumor cells. They are characterised by high nuclear-cytoplasmic ratios. Their cytoplasm is scanty, delicate, with indistinct borders. Nuclei are round or spindle-shaped, with irregular borders and numerous mitoses. Typically, chromatin is coarsely clumped with margination on the nuclear border. Cells tend to mold a little on each other. Groups are loosely cohesive, sometimes displaying a "feathering" effect like in the classical adenocarcinoma of the cervix. In our case, tumor cells were numerous, isolated or in small groups, scattered against a tumor diathesis type of background.

Differencial diagnosis can be very difficult between high grade intraepithelial lesion or endometrioid adenocarcinoma. This tumor must not be confused with carcinoid, which is a slow-growing tumor. A new terminology is currently under discussion.

52 year old woman. 4th day of cycle in perimenopause. Our diagnosis was done in cytology on a routine liquid medium (ThinPrep®) routine PAP smear and confirmed by immunocytochemie (synaptophysine and neuron-specific enolase) and later by histology.

  
  Necrotic and bloody background. Numerous isolated and grouped tumor cells. Numerous mitoses.  
       
  Cells are often spindle-shaped. Chromatin is coarse and concentrate around cel membrane (group on the upper left). "Feathering effect".  
       
  Close-up on the spindle-shaped cells with coarsely clumped chromatin.  
       
  Tumor cells largely infiltrate the cervix. Numerous mitoses. No glandular nor rosette formations.  
       
 
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  Dernière mise à jour: le 31 janvier, 2004    
 

Pour en savoir plus:

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