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Results of a Workshop Sponsored by the College of American Pathologists and the National Cancer Institute
Following the initial description of endocrine tumors of the uterine cervix,1-4 subsequent publications emphasized their broad morphologic spectrum using a variety of descriptive terms.24 More than 15 terms have been used to describe these tumors; the most common are carcinoid tumor,5-8 carcinoid tumor with squamous cell carcinoma,9 carcinoid tumor with adenocarcinoma,10 argyrophil cell carcinoma,ll-13 apudoma,14 poorly differentiated small cell carcinoid,ls small cell tumor with neuroepithelial features,16 nonendocrine carcinoid tumor,l7 endocrine carcinoma intermediate cell type,18 small cell undifferentiated carcinoma,19 oat cell carcinoma,20 small cell carcinoma,21-24 small cell neuroendocrine carcinoma,25 neuroendocrine carcinoma, non-small cell type,26 and adenocarcinoma with carcinoid features.27
As a result, it has been difficult to compare the incidence, clinicopathologic features, biological behavior, and natural history of these unusual tumors. For this reason a Workshop was cosponsored by the Cancer Committee of the College of American Pathologists and the National Cancer Institute to discuss and recommend a uniform terminology that is simple, reproducible, understandable, and useful.
Since the morphologic features of endocrine tumors of the uterine cervix are comparable to those occurring in the lung,2-4,28-29 the Workshop benefited from a discussion of the histologic features and biologic behavior of pulmonary endocrine tumors. The participants also reviewed the terminology and morphologic features of endocrine tumors occurring in the ovary and in the gastrointestinal tract.
Prior to reaching a consensus, the participants acknowledged that these tumors are infrequent and that our knowledge and experience is limited. Therefore, the following recommendations represent only a first step in improving the current terminology by making it more uniform for pathologists and clinicians. The participants hope that this terminology of endocrine tumors of the uterine cervix will be adopted by all pathologists and clinicians, thereby leading to a better understanding of the biology, therapy, and natural history of these lesions. Moreover, a uniform classification should provide a common reference for future molecular pathology studies.
DEFINITIONS
To reduce the number of terms currently used to describe these lesions, the participants recommended the following four general categories for endocrine tumors of the uterine cervix.
Typical (Classical) Carcinoid Tumor
Typical carcinoid tumors display trabecular, nodular, or cordlike architectural patterns. Rosette-like structures are common, but follicles filled with...