Cytologic features of gastric-type endocervical adenocarcinoma: Three cases report and literature review

胃型宫颈内膜腺癌的细胞学特征:三例病例报告及文献复习

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Abstract

RATIONALE: Cervical gastric-type adenocarcinoma shows gastric differentiation, and the tumor cell morphology appears benign and unrelated to human papillomavirus, which makes cervical gastric-type adenocarcinoma highly susceptible to misdiagnosis as normal glandular epithelium in cytologic diagnosis. PATIENT CONCERNS: We present 3 cases of gastric-type adenocarcinoma, with the first being a 57-year-old female with abnormal uterine bleeding and fluid drainage. The second patient was a 63-year-old female, and the third was a 59-year-old female with irregular vaginal bleeding after menopause. DIAGNOSIS: The 3 patients were diagnosed with cervical gastric-type adenocarcinoma by combining their history, clinical data, cytopathology, histopathology, and immunohistochemistry. INTERVENTIONS: Patient 1 underwent total hysterectomy and adnexectomy, but refused radiotherapy and chemotherapy. Patient 2 received a chemotherapeutic regimen, and patient 3 was treated with traditional Chinese medicine. OUTCOMES: Patient 1 was followed-up for 9 months and is currently in good general condition, while patients 2 and 3 were not followed-up. LESSONS: The "drunken honeycomb" cell arrangement is diagnostically important in liquid-based cytology, especially when three-dimensional spheroids are present, and may be a characteristic cytological finding of well-differentiated cervical gastric-type adenocarcinoma.

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