자궁경부에서 하나의 종양 안에 동시 발생한 선암종과 소세포암: 증례 보고
COMBINED SMALL CELL CARCINOMA AND ADENOCARCINOMA ARISING IN UTERINE CERVIX
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본 저자들은 자궁경부에서 병발한 소세포암과 선암종 1예에 대해 보고한다. 39세 여성 환자가 자궁경부에 발생한 종괴를 주소로 내원하였다. 질확대경 생검상 선암종으로 진단하였고 근치 자궁절제술을 시행받았다. 종괴는 약 2.0 cm 크기의 장경을 가지고 있었으며 주로자궁경부내로 침습하여 자라고 있었다. 현미경적으로 종괴는 자궁경부의 2시부터 9시 방향까지는 분화가 좋은 선암종의 형태였으나, 9시부터 11시 방향까지는 짙은 핵염색상을 보이며 조밀한 과립형 핵염색질과 특징적인 핵성형을 보이는 소세포암이었다. 특수 염색 및 면역 조직 화학 염색상, 선암종 부위는 점액 염색과 carcinoembryonic antigen에 양성이었고 소세포암 부위에는 면역 조직 화학 염색중 신경내분비 표지자인 chromograninA와 synaptophysin에 양성이었다. 본 증례는 자궁경부에서 소세포암과 선암종이 병발할 수 있음을 시사해준다.
Abstract
We report here on a case of combined small cell carcinoma and adenocarcinoma arising on uterine cervix. The patient was a 39-year-old woman who presented with uterine cervical mass. Colposcopic biopsy confirmed as adenocarcinoma and radical hysterectomy was performed. The mass, measuring in about 2 cm in greatest diameter, was mainly endophytic growing. Histopathologically, the mass was consisted of well differentiated adenocarcinoma from 2 to 9 o’clock directions of uterine cervix. From 9 to 11 o’clock directions, small cell carcinoma was detected. On results of special stain and immunohistochemistry, mucin stains and carcinoembryonic antigen were positive in area of adenocarcinoma. Chromogranin A and synaptophysin, stain for neuroendocrine markers, were positive in region of small cell carcinoma. This case indicates that the small cell carcinoma and adenocarcinoma can simultaneously occur in uterine cervix.
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