Cytopathology. 2021 Oct 7. doi: 10.1111/cyt.13066. Online ahead of print.
ABSTRACT
INTRODUCTION: Uterine clear cell adenocarcinoma (CCC) is a rare, aggressive malignancy with a poor prognosis. The present study was conducted to study and describe the characteristic morphologic features of uterine clear cell carcinoma (CCC) in cervical cytology.
METHODS: This was a 3-year retrospective case-control study. Cervical samples of women with histopathologically proven endometrial and cervical clear cell carcinoma were included as cases. Controls included cervical samples from histopathologically proven endometrial serous carcinoma(n=15), endometrioid adenocarcinoma(n=20) and endocervical adenocarcinoma(n=15). Twenty-eight cytomorphologic features were evaluated; the strength of association was determined by Odds ratio (OR), and Cramer’s V. Diagnostic accuracy of statistically significant features was also determined.
RESULTS: A total of 72 CCCs of the female genital tract, including 25(34.7%) endometrial CCC and 13(18.0%) cervical CCC, were reported on histopathology during the study period. Corresponding cervical samples were available for a total of 14(36.8%) patients, of which 13(92.8%) were found to be positive for epithelial cell abnormality. On univariate analysis, 3/28 cytomorphologic variables were found to be significant predictors of uterine CCC, viz. presence of dense cytoplasm(OR=88;V=0.72), deep nuclear membrane irregularities(OR=17.5;V=0.55) and coarse chromatin(OR=21.3;V=0.46). The presence of dense cytoplasm was noted to have the highest positive predictive value(92%) and high specificity(97.8%). In contrast, coarse chromatin was noted to have the highest sensitivity(92.3%) and negative predictive value(96.7%).
CONCLUSIONS: The presence of dense cytoplasm and deep nuclear membrane irregularities in the tumor cells were found to be strong predictors and coarse chromatin, a moderate predictor of uterine CCC compared to its close cytologic mimics.
PMID:34619807 | DOI:10.1111/cyt.13066
