Cervix
Carcinoma
Adenoid basal carcinoma



Topic Completed: 1 February 2017

Revised: 25 September 2019

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Adenoid basal carcinoma cervix


Ashwyna Sunassee, M.D.
Ryan W. Askeland, M.D.
Page views in 2018: 3,039
Page views in 2019 to date: 2,846
Cite this page: Sunassee A. Adenoid basal carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixadenoidbasal.html. Accessed October 22nd, 2019.
Definition / general
  • Very rare indolent tumor with favorable clinical course and excellent prognosis
  • Affects older postmenopausal women, often non - white
  • Usually diagnosed retrospectively on surgical specimens
  • Rare metastases
Essential features
  • Very rare indolent tumor with favorable clinical course and excellent prognosis
  • Affects postmenopausal women, non white
  • Important to distinguish from adenoid cystic carcinoma due to different clinical behavior
  • Associated with squamous intraepithelial lesions (SIL)
Terminology
Epidemiology
Pathophysiology
Etiology
Clinical features
  • 80 - 90% are asymptomatic but have an abnormal pap smear - usually high grade squamous intraepithelial lesion
  • May have vaginal bleeding
Prognostic factors
  • Excellent prognosis with low potential for metastasis and recurrence
  • Morphologically pure lesions usually have favorable outcome
Case reports
Treatment
  • Conservative - LEEP, conization
Gross description
  • Cervix with no gross abnormality, rarely ulceration
Microscopic (histologic) description
  • Solid basaloid tumor nests with peripheral palisading or cord like arrangement and some microcyst formation (Diagn Pathol 2006 Aug 16;1:20)
  • May form acini structures without hyaline material
  • Uniform, round to oval cells with scant cytoplasm, small hyperchromatic nuclei with inconspicuous nucleoli and minimal nuclear atypia (J Pathol Transl Med 2015;49:396)
  • No desmoplastic stroma (J Menopausal Med 2013;19:154)
  • Associated with SIL (usually HSIL)
Microscopic (histologic) images
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Rounded nests of basaloid cells infiltrating the stroma

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Small nests of round small cells

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Small acini

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Palisading arrangement around cellular nest

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Cervical stroma



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Cytologic and histopathologic features

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IHC stains

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EMA

Cytology description
  • Often no findings or unrecognized on cytology, as many cases do not involve surface
  • Usually associated with HSIL and hence detected on Pap, HPV 16+
  • Three dimensional, somewhat dyscohesive groups of intact small and uniform cells with overlapping nuclei (Acta Cytol 1995;39:563)
  • Occasional peripheral palisading
  • No glandular formation
  • Scant cytoplasm (Diagn Cytopathol 1996;14:172)
  • Dense basophilic, hyperchromatic nuclei with fine granular chromatin (J Pathol Transl Med 2015;49:396) and small / inconspicuous nucleoli
  • "Windswept appearance" when compared to reactive atypia (Acta Cytol 1995;39:563)
Positive stains
Negative stains
Differential diagnosis
  • Adenoid basal hyperplasia: absence of deep invasion into stroma
  • Adenoid cystic carcinoma: Collagen IV, laminin, CD117+, cribriform nests with hyaline material, coarse granular chromatin, more aggressive
  • Invasive squamous cell carcinoma: tumor diathesis, single cells, variation in size of nuclei
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