Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
© 2015 The Korean Society of Pathologists/The Korean Society for Cytopathology
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Conflicts of Interest
No potential conflict of interest relevant to this article was reported.
Cytologic features | Adenoid cystic carcinoma | Adenoid basal carcinoma |
---|---|---|
Background | Bloody and necrotic; orangeophilic globules | Necrotic, mostly |
Architecture | Three-dimensional clusters; occasionally glandular structures; opaque materials in the center of the glands | Three-dimensional clusters of sheets; nuclear overlapping; rarely peripheral palisading |
N/C ratio | Moderate to high | High |
Nuclear shape | Round to oval | Round to oval |
Nuclear size (μm) | 5–7a | 3–4a |
Nuclear size variation | Mild to moderateb | Mildb |
Mitotic counts (/100–150 cells) | 2–3 | 0–1 |
Chromatin pattern | Hyperchromatic; coarse granular chromatin pattern | Hyperchromatic; finely granular chromatin pattern |
Nucleoli | Rarely seen; indistinct, mostly | Rarely seen; small nucleoli, occasionally |
ACC (n = 117) | ABC (n = 218) | p-valuea | |
---|---|---|---|
Area (µm2) | 18.556 ± 8.655 | 11.017 ± 4.440 | < .001 |
Circumference (µm) | 23.320 ± 11.412 | 15.920 ± 5.664 | < .001 |
Major axis (µm) | 5.664 ± 1.537 | 4.612 ± 1.025 | < .001 |
Minor axis (µm) | 4.127 ± 1.107 | 3.088 ± 0.762 | < .001 |
Case No. | Age (yr) | Cytologic diagnosis | Surgical procedure | Histologic diagnosis | Combined lesion |
---|---|---|---|---|---|
1 | 76 | SCC | Punch biopsy | ACC | - |
2 | 45 | AC | Hysterectomy | ACC | - |
3 | 68 | MN | Hysterectomy | ACC | SD |
4 | 78 | SCC, AC | Punch biopsy | ABC | SCC |
5 | 62 | SCC | Hysterectomy | ABC | SCC |
6 | 56 | SCC | Hysterectomy | ABC | SCC |
7 | 62 | SCC | Hysterectomy | ABC | - |
8 | 68 | ASCUS | Hysterectomy | ABC | SCC |
Cytologic features | Adenoid cystic carcinoma | Adenoid basal carcinoma |
---|---|---|
Background | Bloody and necrotic; orangeophilic globules | Necrotic, mostly |
Architecture | Three-dimensional clusters; occasionally glandular structures; opaque materials in the center of the glands | Three-dimensional clusters of sheets; nuclear overlapping; rarely peripheral palisading |
N/C ratio | Moderate to high | High |
Nuclear shape | Round to oval | Round to oval |
Nuclear size (μm) | 5–7 |
3–4 |
Nuclear size variation | Mild to moderate |
Mild |
Mitotic counts (/100–150 cells) | 2–3 | 0–1 |
Chromatin pattern | Hyperchromatic; coarse granular chromatin pattern | Hyperchromatic; finely granular chromatin pattern |
Nucleoli | Rarely seen; indistinct, mostly | Rarely seen; small nucleoli, occasionally |
ACC (n = 117) | ABC (n = 218) | p-value |
|
---|---|---|---|
Area (µm2) | 18.556 ± 8.655 | 11.017 ± 4.440 | < .001 |
Circumference (µm) | 23.320 ± 11.412 | 15.920 ± 5.664 | < .001 |
Major axis (µm) | 5.664 ± 1.537 | 4.612 ± 1.025 | < .001 |
Minor axis (µm) | 4.127 ± 1.107 | 3.088 ± 0.762 | < .001 |
Differential diagnosis | Nuclear features | Cytologic features | Structures |
---|---|---|---|
SCC, keratinizing | Marked variation in size and shape; irregular nuclear membrane; coarsely granular and irregularly distributed chromatin | Dense orangiophilic | Low cellularity; single cells and less commonly in aggregates |
SCC, nonkeratinizing | Smaller than HSIL; markedly irregular distributed chromatin | Basophilic | Single or aggregated cells |
Small cell carcinoma | Small, relatively uniform cells; hyperchromatic with granular or stippled chromatin; frequent mitosis; inconspicuous nucleoli | Scant cyanophilic cytoplasm | Singly and in groups with nuclear molding |
Endocervical adenocarcinoma | Columnar configuration enlarged, pleomorphic nuclei; irregular nuclear membrane; macronucleoli | Usually finely vacuolated | Abundant abnormal cells; single cells or two-/three-dimensional sheets; discohesive groups |
Endometrial carcinoma | Variation of nuclear size; loss of nuclear polarity; moderate hyperchromasia; large with clumped chromatin; small to prominent nucleoli | Scant, cyanophilic, often vacuolated; commonly intracytoplasmic neutrophil | Single or small, tight clusters |
Benign endometrial stromal cells | Small round to oval shape; inconspicuous nucleoli | Scant, basophilic, or occasionally vacuolated | Three-dimensional ball-like clusters; double-contoured cluster (the first half of the menstrual cycle) |
Atrophy | Intermediate cells with normochromatin; elongated nuclei; mild hyperchromasia | - | Flat, monolayer sheets |
SCC, squamous cell carcinoma; ACC, adenoid cystic carcinoma; AC, adenocarcinoma; MN, other malignant neoplasm; SD, squamous differentiation; ABC, adenoid basal carcinoma; ASCUS, atypical squamous cells of undetermined significance.
Estimate based on major axis in our cases; Estimate based on major axis with standard deviation in our cases.
Values are presented as mean ± standard deviation. ACC, adenoid cystic carcinoma; ABC, adenoid basal carcinoma. Statistical significance was determined by Mann-Whitney U-test.
SCC, squamous cell carcinoma; HSIL, high grade intraepithelial lesion.