Document Detail

Cytology of metastatic cervical squamous cell carcinoma in pleural fluid: report of a case confirmed by human papillomavirus typing.
MedLine Citation:
PMID:  19217045     Owner:  NLM     Status:  MEDLINE    
Cervical squamous cell carcinomas are rarely the cause of malignant effusions. Their identification can be relatively easy when keratinizing atypical squamous cells are present, but may be very difficult when only nonkeratinizing malignant cells are present. We present the case of a 47-year-old woman who presented with a large left pleural effusion after having recently completed chemoradiation therapy for stage IIB cervical squamous cell carcinoma. Cytologic examination of the fluid showed a uniform population of single atypical cells with finely vacuolated cytoplasm, ectoendoplasmic demarcation, cell-in-cell arrangements, and short rows of cells with intervening "windows," all features reminiscent of mesothelial cells. No keratinization or three-dimensional cell clusters were identified. A panel of immunohistochemical stains was performed on the cell block material, and the atypical cells were positive for cytokeratin 5/6, p63, and p16 but not for cytokeratin 7, calretinin, WT1, or Ber-EP4 or TTF1. These findings were consistent with metastatic squamous cell carcinoma. HPV DNA determination and typing by PCR confirmed the presence of HPV16 in an aliquot of pleural fluid. This is to our knowledge the first reported case of pleural fluid involved by metastatic squamous cell carcinoma where HPV DNA testing was used to confirm the origin of the metastasis. Despite its rarity, metastatic nonkeratinizing squamous cell carcinoma should be considered when a single cell population of large atypical cells is found in effusions. Immunoperoxidase stains and HPV testing can be performed to establish the diagnosis and confirm the origin from a cervical primary.
Roberto G Gamez; Jose Jessurun; Michael J Berger; Stefan E Pambuccian
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Diagnostic cytopathology     Volume:  37     ISSN:  1097-0339     ISO Abbreviation:  Diagn. Cytopathol.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-14     Completed Date:  2009-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506895     Medline TA:  Diagn Cytopathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-7     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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MeSH Terms
Carcinoma, Squamous Cell / pathology*
Human papillomavirus 16 / classification*
Middle Aged
Neoplasm Metastasis
Pleural Effusion, Malignant / pathology*,  virology*
Pleural Neoplasms / secondary*
Polymerase Chain Reaction
Uterine Cervical Neoplasms / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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