Zusammenfassung
Neuroendokrine Karzinome der Zervix sind selten. Sie treten beginnend vom jungen Erwachsenenalter bis ins hohe Lebensalter auf. Zwei Typen werden unterschieden: kleinzelliges Karzinom („oat cell“) und großzelliges neuroendokrines Karzinom. Beide können in Kombination mit einem Adenokarzinom oder einem Plattenepithelkarzinom der Zervix vorkommen. Immunhistochemisch findet sich eine konstante Expression zumindest eines neuroendokrinen Markers (Chromogranin, Synaptophysin, NSE) und von p16INK4a. Eine Expression des Retinoblastomproteins (pRb) wird nicht beobachtet. Die Expression von p53 ist inkonstant. Typischerweise findet sich eine Assoziation mit einer „High-risk-HPV Infektion“, wobei HPV18 häufiger nachgewiesen wird als HPV16. Die Prognose ist ungünstig, da schon früh Lymphknotenmetastasen und hämatogene Metastasen in Lunge, Leber, Knochen und Gehirn auftreten.
Abstract
Neuroendocrine carcinomas of the cervix are rare. They cover a wide age range occurring in young adult women and very old women. Two types are distinguished: small cell carcinoma (oat cell) and large cell neuroendocrine carcinoma. They either occur in pure form or in combination with adenocarcinoma or squamous cell carcinoma. By immunohistochemistry, the expression of at least one neuroendocrine marker (chromogranin, synaptophysin, NSE) is a constant finding. PRb protein can not be detected, whereas the expression of p53 varies. Typically, there is an association with a high risk HPV infection. HPV 18 is found more often than HPV 16. The prognosis is still poor with early metastases to regional lymph nodes and distant sites such as lung, liver, bone, and brain.
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Schmidt, D., Horn, LC. & Kommoss, F. Neuroendokrine Karzinome der Cervix uteri. Pathologe 26, 262–265 (2005). https://doi.org/10.1007/s00292-005-0766-1
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DOI: https://doi.org/10.1007/s00292-005-0766-1