Morphological Changes Induced by Neoadjuvant Chemotherapy in the Invasive Squamous Cell Carcinoma of Uterine Cervix
JS Song, SA Kim, JY Ro, K-R Kim. University of Ulsan College of Medicine, Seoul, Republic of Korea
Background: Neoadjuvant chemotherapy (NAC) has emerged as a possible alternative, which may improve a survival rate in patients with locally advanced malignant disease. In the squamous cell carcinoma of the uterine cervix, we observed that some of the histologic changes after NAC mimic prognostically important histologic variants of cervical carcinoma, or produce histologic mimicry of prognostically significant histologic parameters. Nevertheless, histological changes after NAC have rarely been described and underrecognized among pathologists.
Design: This study comprised 88 radical hysterectomy specimens including 44 invasive squamous cell carcinomas in advanced stage after receiving a platinum-based NAC, and 44 age matched controls without NAC. We compared the H&E findings to recognize the histologic changes induced by NAC.
Results: Cytoplasmic vacuolization and microcystic change mimicking adenoid cystic carcinoma, pseudopapillary arrangement simulating papillary serous adenocarcinoma, peritumoral cleft mimicking lymphovascular tumor emboli, were far more frequent in NAC group, although they were not statistically significant. Moreover, histiocytic infiltration (p<0.001), thick walled blood vessel (p<0.001), single isolated tumor cell in the stroma (p=0.003), and abrupt keratinization (p=0.007) were significantly more frequent in NAC group, suggesting that those findings were induced by NAC.
Conclusions: The pathologist's knowledge regarding chemotherapy-induced morphological changes is important to avoid a possible misdiagnosis.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 178, Tuesday Morning