{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:21:39Z","timestamp":1785248499756,"version":"3.55.0"},"reference-count":4,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2018,5,22]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"\n Clinical question<\/jats:title>\n A 45-year-old woman presented with painless vaginal bleeding for 2 months. A biopsy was taken from the uterine cervix, and\u00a0poorly differentiated adenocarcinoma was suspected. After three cycles of neoadjuvant chemotherapy treatment, the patient underwent radical hysterectomy with bilateral salpingo-oophorectomy, and\u00a0pelvic and para-aortic lymphadenectomy.<\/jats:p>\n \n Review the high\u00a0quality, interactive digital Aperio slide at\u00a0\n http:\/\/virtualacp.com\/JCPCases\/jclinpath-2018-205081-1\/<\/jats:ext-link>\n and consider your diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n What is your diagnosis?<\/jats:title>\n \n \n Typical carcinoid.<\/jats:p>\n <\/jats:list-item>\n \n Poorly differentiated adenocarcinoma.<\/jats:p>\n <\/jats:list-item>\n \n Atypical carcinoid.<\/jats:p>\n <\/jats:list-item>\n \n Small cell neuroendocrine carcinoma.<\/jats:p>\n <\/jats:list-item>\n \n Sex cord-stromal tumours of the\u00a0uterine cervix.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n \u00ad<\/jats:p>\n The correct answer is after the discussion.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Neuroendocrine tumours of the uterine cervix are a\u00a0rare cancer of the female reproductive system, accounting for approximately 1% of all female cervical malignancies.1 2 In 1997, a consensus workshop suggested four types of neuroendocrine tumours of the uterine cervix: typical and atypical carcinoid tumours, small cell neuroendocrine carcinomas, and large cell carcinomas.1 Among all the categories, small cell neuroendocrine carcinomas are of the highest incidence. A PubMed search revealed that\u00a0only 15 cases of atypical carcinoid tumours of the uterine cervix have been reported.3 4 Because of infrequency, the clinical and pathological features of atypical carcinoid tumours of the uterine cervix remain unknown.<\/jats:p>\n Atypical carcinoids are characterised by great cytological atypia, which means abundant or scanty cytoplasm and visible nucleoli with granular chromatin. Tumour cells lined up in insular, trabecular, columnar and nested organoid patterns; they are epithelioid in appearance, but can be spindled\u00a0(figure 1A). Necrosis could be observed in some areas and mitotic activity is up to 10 mitotic figures\/10\u00a0high-power field (figure 1B). On immunohistochemistry, atypical carcinoids are diffuse and\u00a0positive for Syn, CgA and CD56\u00a0(figure 2). An\u00a0electron microscopic test was done, and several\u00a0neuroendocrine granules were distributed in the\u00a0tumour cell plasma\u00a0(figure 3).<\/jats:p>\n \n Figure 1<\/jats:label>\n \n (A)\u00a0Insular, trabecular and columnar patterns of tumour cells were focally observed in the deep stroma of the\u00a0cervix (H&E \u00d7200). (B) Tumour cells showed small-sized, scanty cytoplasm, enlarged and deeply stained nuclei with condensed chromatin, obvious atypia, and increased mitotic activity\u00a0(H&E \u00d7400). (C) The cervical gland has\u00a0shown atypical hyperplasia and adenocarcinoma in situ (H&E \u00d7200).<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n \n Figure 2<\/jats:label>\n \n Immunohistochemical study findings: (A\u2013C) The neuroendocrine markers Syn, CgA and CD56 were diffuse with\u00a0strong expression in the tumour cell\u00a0plasma. (D\u2013E)\u00a0P63 and CK5\/6 for the squamous cell carcinomas showed no expression. (F\u2013G) P16 for atypical carcinoid and adenocarcinoma in situ, respectively, had\u00a0strong diffuse expression. (H\u2013I)\u00a0Ki67 had\u00a0low expression in both atypical carcinoid and adenocarcinoma in situ (\u00d7200).<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n \n Figure 3<\/jats:label>\n \n Several\u00a0neuroendocrine granules were distributed in the\u00a0tumour cell plasma.<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n Neuroendocrine tumours of the uterine cervix are sometimes combined with adenocarcinoma\u00a0(figure 1C); their cytological and immunohistochemical features showed the neuroendocrine and adenomatous components shared the same origin.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/jclinpath-2018-205081","type":"journal-article","created":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T17:51:35Z","timestamp":1535478695000},"page":"1030-1030","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Atypical carcinoid of the uterine cervix accompanying adenocarcinoma in situ"],"prefix":"10.1136","volume":"71","author":[{"given":"Chen","family":"Ling","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, People\u2019s Republic of China"},{"name":"West China School of Medicine, Sichuan University, Chengdu, People\u2019s Republic of China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9033-6998","authenticated-orcid":false,"given":"Yangmei","family":"Shen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People\u2019s Republic of China"},{"name":"Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,28]]},"reference":[{"key":"2025121322091777000_71.11.1030.1","first-page":"34","article-title":"Terminology of endocrine tumors of the uterine cervix: results of a workshop sponsored by the College of American Pathologists and the National Cancer Institute","volume":"121","author":"Albores-Saavedra","year":"1997","journal-title":"Arch Pathol Lab Med"},{"key":"2025121322091777000_71.11.1030.2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ygyno.2016.02.008","article-title":"Natural history and outcome of neuroendocrine carcinoma of the cervix","volume":"141","author":"Margolis","year":"2016","journal-title":"Gynecol Oncol"},{"key":"2025121322091777000_71.11.1030.3","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/j.1447-0756.2010.01402.x","article-title":"Atypical metastatic carcinoid of the uterine cervix and review of the literature","volume":"37","author":"Yoshida","year":"2011","journal-title":"J Obstet Gynaecol Res"},{"key":"2025121322091777000_71.11.1030.4","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1002\/dc.21657","article-title":"Cytological features of atypical carcinoid combined with adenocarcinoma of the uterine cervix","volume":"40","author":"Hara","year":"2012","journal-title":"Diagn Cytopathol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2018-205081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T06:09:34Z","timestamp":1765692574000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2018-205081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,28]]},"references-count":4,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2018,10,17]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/jclinpath-2018-205081"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2018-205081","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,28]]}}}