High-grade neuroendocrine carcinoma of uterus: a report of 25 cases and clinicopathological study
10.13315/j.cnki.cjcep.2017.09.002
- VernacularTitle:子宫高级别神经内分泌癌25例临床病理分析
- Author:
Xin JIN
1
;
hui Xiao SUN
;
Bo YU
;
jun Shao JIANG
;
feng Zhen LU
;
li Qun SHI
;
Qin SHEN
Author Information
1. 南京军区南京总医院病理科
- Keywords:
uterus neoplasm;
neuroendocrine neoplasm;
high-grade;
immunohistochemistry;
ultrastructure
- From:
Chinese Journal of Clinical and Experimental Pathology
2017;33(9):950-954
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the pathological morphology and diagnostic parameters in the high-grade primary neuroendocrine carcinoma (NECa) of the uterus.Methods The clinical manifestations,pathological morphology,and immunohistochemical features of 25 uterine high-grade primary NECa cases were analyzed,and the relevant literatures were reviewed.Results The age of the 25 patients ranged from 24 to 72 years (mean age,44 years).Clinically,most of them complained of the vaginal bleeding or occupying lesions.84％ cases displayed typical neuroendocrine architectures histologically,and neurosecretory granules were observed in the electron microscopy examination.The nucleus of the small-cell type and large-cell type NECa were typical.Additionally,the mitosis number was more than 20/10 HPF in 64％ cases,10 to 20/10 HPF in 28％ cases,and less than 10/10 HPF in 8％ cases.Furthermore,highgrade NECa was often accompanied with apoptosis (72％) and necrosis (92％).The diagnosis included 13 cases of small-cell carcinoma,5 cases of combined small-cell carcinoma (1 with cervical intraepithelial neoplasia 3,1 with squamous cell carcinoma,and 1 with adenocarcinoma),4 cases of large-cell NECa,and 3 cases of combined large-cell NECa (2 with squamous cell carcinoma,and 1 with adenocarcinoma).The neuroendocrine markers were positive with Syn (96％),CgA (70.5％) and CD56 (78.6％).76.9％ cases demonstrated CKpan positivity,with small foci or linetype of cytoplasmic immunostaining.The proliferation index of Ki-67 was ranged from 60％ to 90％.In this study,13 patients received the uterus excision with adjuvant chemotherapy,and 5 cases died within 2 years.Conclusion High-grade NECa of the uterus is rare,and the terminology is similar to that of the digestive tract and lung.Yet,the diagnostic parameters are slightly different to some extent.The therapy is the surgical resection followed by adjuvant chemotherapy.
