Minimal deviation
adenocarcinoma (MDA), or
adenoma malignum, of the uterine cervix is a diagnostically problematic disease because of the difficulty in differentiating it histologically from normal cervical glands. To evaluate the use of
mucin phenotyping for differentiating MDA from other conditions, we performed
alcian blue pH 2.5/
periodic acid-Schiff (AB-PAS) staining and high
iron diamine (
HID)-AB staining on routinely processed sections of 11 MDAs, 20 unremarkable cervical glands, 9 cervical glandular
hyperplasias occurring in association with mucinous ovarian
tumors, and 41 conventional cervical
adenocarcinomas. In all 11 MDAs and 11 conventional cervical
adenocarcinomas, the
tumor cell cytoplasm was stained diffusely red by PAS, indicating that MDA cells produce neutral
mucin almost exclusively. The amount of
acid mucins, both
sulfomucin and
sialomucin, was decreased markedly by
HID-AB. For four MDAs, preoperative biopsy specimens also showed diffuse cytoplasmic neutral
mucin. In contrast, the cytoplasm of constituent cells was stained purple to violet by AB-PAS in all unremarkable cervical glands and glandular
hyperplasias, indicating that both
acid and neutral
mucins were produced in equal amounts,
sulfomucin being stained predominantly by
HID-AB. Of the 30 conventional cervical
adenocarcinomas, 28 showed both
acid and neutral
mucins and two showed
acid mucin only in goblet cells, or in part of the cytoplasm or cell surface of constituent cells, where
acid mucin consisted predominantly of
sulfomucin in 14 and
sialomucin in 16. AB-PAS and
HID-AB are simple and orthodox histochemical methods which are effective for differential diagnosis of MDA and can contribute to its early detection and treatment.