Cytological and clinicopathological studies of adenoma malignum of the uterine cervix.

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We studied histopathologically seven cases of adenoma malignum of the uterine cervix were studied. The results were as follows: 1. The cases ranged in age from 35 to 58 years, with a mean age of 48 years. 2. The clinical symptoms and signs of seven cases were vaginal bleeding, vaginal discharge, and hypertrophy of the cervix. 3. The clinical staging (FIGO) varied stage four cases, of stage Ib two cases of stage II and case of stage III. 4. Six cases were treated by radical hysterectomy and pelvic lymph node dissection. Two cases with pelvic lymph node metastasis were treated by operation plus irradiation, but showed tumor recurrence and died within three years. 5. The Papanicolaous classification of the initial smear test obtained by scraping was class III in five cases, class IV in one and class V in one. 6. The cytologic characteristics of the cervical smear were 1) clean background appearance, 2) multilayered or side-by-side arrangement of tumor cells, 3) abundant lacy or vacuolated cytoplasms, 4) round or oval nuclei with occasional prominent nucleoli, 5) granular chromatin pattern, and 6) increased N/C ratio. 7. The histological diagnosis of the initial cervical biopsy specimens was adenoma malignum in only two cases and atypical glands and/or cervicitis in five.
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