Email updates

Keep up to date with the latest news and content from Diagnostic Pathology and BioMed Central.

Open Access Case Report

Coexistence of early microinvasive endometrioid adenocarcinoma and CIN3 in the uterine cervix in a 32-year-old Japanese woman

Tadashi Terada

Author Affiliations

Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231 Shimizu-Ku, Shizuoka 424-8636, Japan

Diagnostic Pathology 2011, 6:51  doi:10.1186/1746-1596-6-51

Published: 10 June 2011

Abstract

Simultaneous occurrence of early microinvasive endometrioid adenocarcinoma (EMEA) and CIN 3 in the uterine cervix is very rare in Japan. A 32-year-old Japanese woman was pointed out to have atypical cells in the cervical cytology. Colposcopic examination revealed irregular lesions in the cervix, and a biopsy showed simultaneous EMEA and CIN3. The EMEA was grade I and CIN3 corresponded to severe dysplasia/carcinoma in situ. Hysterectomy and lymph nodes dissection were performed. Grossly, mucosal irregularity and erosion were seen in the cervix. No tumor formation was recognized. The cervix was examined by serial sections. Microscopically, there were a tiny adenocarcinoma (0.5 cm in diameter and 0.3 cm in depth) and broad areas of CIN3. The adenocarcinoma was EMEA without mucins. The EMEA was FIGO stage 1A1. Immunohistochemically, the EMEA was positive for pancytokeratins (AE1/2 +++, CAM5.2 ++), cytokeratin (CK) 34βE12 +, CK5/6 +, CK7 +, CK18 +++, CK19 ++, CA19-9 +, CA125 +++, p53 +, ER +++, PgR +++, while it was negative for CK8, CK14, CK20, EMA, vimentin, CEA, desmin, smooth muscle actin, p63, chromogranin, synaptophysin, CD56, CD68, HER2/neu, MUC1, MUC2, MUC5AC, and MUC6. The CIN 3 was positive for pancytokeratins (AE1/2 +++, CAM5.2 +), cytokeratin (CK) 34βE12 +++, CK5/6 +++, CK7 +, EMA, CA19-9 +, CA125 +, p53 +, p63 +++, ER +++, and MUC1 +, while it was negative for CK8, CK14, CK18, CK19, CK20, vimentin, CEA, desmin, smooth muscle actin, chromogranin, synaptophysin, CD56, CD68, PgR, HER2/neu, MUC2, MUC5AC and MUC6. The lymph nodes showed no metastatic lesions (0/34). In conclusion, the author reported a rare case of simultaneous EMEA and CIN 3 with extensive immunohistochemical findings.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2229343835388013 webcite.

Keywords:
early microinvasive adenocarcinoma; CIN3; uterine cervix; histopathology; immunohistochemistry