CASE N°47 – Pleural Fluid, signet ring carcinoma

Clinical History:

Age: 60

Sex: Male

Six months ago esophago-gastrectomy for adenocarcinoma of the gastric curve. Histology: adenocarcinoma, signet-ring cell type at follow-up the patient has difficulty breathing.
MRI: Presence of some retroperitoneal lymph nodes and a node of about 14 mm at the para-aortic level.
Bilateral pleural effusions evident on the right.
Poor groundwater intra-abdominal fluid, peri-hepatic.

Image:

cytological speciemen: Pleural fluid

compsit an cast MTS pleura

Cytological Report:

Presence of many epithelial malignant tumor cells isolated, with eccentric nucleus and large cytoplasmic vacuoles, mixed with rare mesothelial cells, some lymphocytes and granulocytes.
Positive for malignancy. Cytologic Finding consistent with localization of adenocarcinoma of the stomach, signet-ring type.

Discussions:

One common phenotypic appearance of gastric cancer is a signet-ring-type

cytomorphology. As seen here, the malignant cells display large cytoplasmic

vacuoles containing mucin with eccentrically placed nuclei and

macronucleoli.

References:

Syed Z.Ali Edmund S.Cibas Serous Cavity Fluid and cerebrospinal fluid Cytopathology. Essentials in Cytopathology, series Editor Dorothy L.Rosenthal. Springer, 96

 

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