CASE N°49 – Cerebrospinal Fluid, signet ring carcinoma

Clinical History:

Age: 55

Sex: Male

May 2013 EGD 4cm lesion infiltrating the structures surrounding the esophagus fat associated with multiple
enlarged lymph nodes in the peri-esophageal and tripod; was also reported the presence of a hypoechoic liver lesion suspicious for secondary lesion. CT thorax, abdomen confirmed the clinical situation

June 2013 uptake only at the level of the lesion esophagogastric

August 2013 Carcinoma of the esophagogastric junction. Histological type: a signet-ring cell

July 2014 emergency room visit: paresthesia left leg with pain in the gluteal area. difficult to stand up

MRI brain: Presence of hyperdense image of about 13 mm at right cerebellar pontine possible expression
of small meningioma, useful specialist assessment and possible investigation

Image:

cytological speciemen: (A-F) Cerebrospinal Fluid

histological speciemen: (G-H) esophagogastric junction, biopsy (related to previous surgery 1 year ago)

49 10176 composit anel caston liq

Cytological Report:

Presence of many epithelial malignant tumor cells isolated, occasionally eccentric nucleus and cytoplasmic vacuoles,
istiomonocitoidi cells, lymphocytes and erythrocytes.
Positive for malignancy. Cytological finding attributable to the location of the disease in history.

Histological Report:

Carcinoma of the esophagogastric junction, signet ring cell 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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