Cervix
Other epithelial tumors
Glassy cell carcinoma
Topic Completed: 1 May 2007
Minor changes: 17 November 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: Glassy cell carcinoma cervix
Table of Contents
Definition / general | Epidemiology | Pathophysiology | Clinical features | Prognosis and treatment | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosis | Additional referencesCite this page: Perunovic B, Sunassee A, Askeland R. Glassy cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixglassycell.html. Accessed January 22nd, 2021.
Definition / general
- Rare variant of poorly differentiated adenosquamous carcinoma (Cytojournal 2013;10:17)
- Aggressive subtype with rapid growth and early metastases
- Poor prognosis (Eur J Obstet Gynecol Reprod Biol 2014;179:232)
Epidemiology
- Younger age group (mean 41 years), associated with pregnancy, HPV 16 and 18 in tumor cells (Cytojournal 2013;10:17)
- Peak incidence 3rd to 4th decades (Cytojournal 2013;10:17)
- Some studies have noted an association with pregnancy
Pathophysiology
- The presence of HPV 18 might stimulate biphasic squamous and glandular differentiation (Int J Gynecol Pathol 2002;21:134)
- Cytokeratin expression is similar to that of reserve cells or immature squamous cells of cervix (Int J Gynecol Pathol 2002;21:134)
Clinical features
- 1 - 2% of cervical carcinomas
- Historically considered more aggressive with poorer prognosis than ordinary adenosquamous carcinoma or adenocarcinoma (APMIS Suppl 1991;23:119), although recent studies show less or no difference (Am J Obstet Gynecol 2004;190:67)
- May have peripheral blood eosinophilia
Prognosis and treatment
Poor prognostic factors:
- Angiolymphatic invasion, deep stromal invasion, large tumor size
- HER2 overexpression may correlate with more aggressive behavior and worse clinical outcome (Acta Cytol 2006;50:418)
Case reports
- 29 year old woman with signet ring cell carcinoma (Pathol Int 2004;54:787)
- 33 year old woman with history of post coital bleeding and vaginal discharge (UPMC Case #100)
- 44 year old and 67 year old women (Ceska Gynekol 1999;64:279, Ginekol Pol 2011;82:936)
Gross description
- Bulky exophytic mass with barrel shape cervix (Cytojournal 2013;10:17)
Gross images
AFIP images
Bulky exophytic mass
Microscopic (histologic) description
- Solid nests of markedly pleomorphic, polygonal tumor cells with prominent cell membrane, glassy and eosinophilic cytoplasm, large eosinophilic nuclei, prominent nucleoli, surrounded by heavy inflammatory infiltrate containing eosinophils
- Frequent mitotic figures
- Pure cases have no histologic evidence of glandular or squamous differentiation (i.e. no intracellular bridges, no dyskeratosis, no intracellular glycogen), which is detectable only by EM
- Often less invasion than is suspected
Microscopic (histologic) images
AFIP images
Sheets of cells with abundant lightly stained cytoplasm
Cells have distinct cell border and prominent nucleoli
Cytology description
- Tumor cells arranged in sheets or clusters
- Distinct cell borders with moderate to abundant finely granular (ground-glass-like) cytoplasm
- Large round/oval vesicular nuclei with one or more prominent nucleoli
- Chromatin varies from finely dispersed (Acta Cytol 2004;48:99) to coarse and irregular (Zhonghua Bing Li Xue Za Zhi 2011;40:523)
- Cytoplasmic vacuolization and bizarre cells with multinucleation may be seen (Acta Cytol 2001;45:407)
- Mitotic figures frequently seen
- Background inflammatory infiltrate including frequent eosinophils, neutrophils, plasma cells, lymphocytes and necrotic debris
- Focal abortive keratin production; squamous or glandular differentiation may be present
- Focal clear cell differentiation may be present
Cytology images
Images hosted on other servers:
Abundant granular cytoplasm
Positive stains
- MUC1 / EMA, MUC2, CEA (focal), CAM5.2, p63 (Zhonghua Bing Li Xue Za Zhi 2011;40:523)
- PAS+ cell wall
- Vimentin
- Focal mucin
Electron microscopy description
- Glassy features may be due to cytoplasmic polyribosomes, abundant tonofilaments and abundant dilated rough endoplasmic reticulum (Am J Clin Pathol 1991;96:520)
- Adenosquamous features include well developed desmosomal complexes and microvilli
- Occasional intracellular lumina (Cancer 1983;51:2255)
Differential diagnosis
- Large cell nonkeratinizing squamous cell carcinoma: cell membrane is less well defined, cytoplasm is less finely granular, coarser chromatin distributed along nuclear membrane; also poor staining or fixation makes it resemble glassy cell carcinoma
- Adenocarcinoma
- Adenosquamous carcinoma
- Lymphoepithelioma-like carcinoma: see Acta Cytol 1999;43:285
Additional references
