Signet Ring Adenocarcinoma Metastatic to the Bronchus and Mimicking Goblet Cell Hyperplasia

Dodd, Leslie G.; Moore, William F.; Eedes, Christopher R.

doi:10.1159/000331362

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…The large vacuoles seen in this case were also reminiscent of neoplastic goblet cells, occasionally seen in salivary gland mucoepidermoid carcinomas, colorectal adenocarcinomas, and appendiceal “goblet‐cell carcinoids” (“adenocarcinoids” or crypt cell carcinomas). The distinction between neoplastic and even benign goblet cells and signet‐ring cells is not always easy . In general neoplastic goblet cells are larger, ovoid rather than round, are seen within cell clusters rather than as single cells, and have less atypical nuclei.…”

Section: Discussionmentioning

confidence: 99%

Cytologic features of pancreatic adenocarcinoma with “vacuolated cell pattern.” report of a case diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration

Samad

Conway

Attam

et al. 2014

Diagnostic Cytopathology

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The "vacuolated cell pattern" has only been recently described as a distinct morphologic variant of pancreatobiliary adenocarcinoma. Herein, we report the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytologic features of a case of pancreatic adenocarcinoma with "vacuolated cell pattern" occurring in a 60-year-old man. The aspirate smears and cell block sections from the EUS-FNA of a 23.5 mm hypoechoic pancreatic head mass were highly cellular, showing variably-sized crowded three-dimensional cell clusters, flat sheets, and numerous highly atypical single cells. The background was bloody and showed necrotic debris, but no discernible mucus. The most striking feature of the aspirate was the presence of numerous very large (20-50 µm) vacuoles, occupying the entire cytoplasm, pushing the nuclei to the side and indenting them, that imparted a cribriform appearance to the sheets of neoplastic cells. The non-vacuolated neoplastic cells were large, had abundant dense (squamoid) cytoplasm, irregularly contoured hyperchromatic nuclei, and prominent macronucleoli. Histologic evaluation of the pancreatectomy specimen showed a "vacuolated cell pattern" adenocarcinoma composed of poorly formed glands, solid sheets, and infiltrating single cells with pleomorphic nuclei and large cytoplasmic vacuoles. To our knowledge, this is the first report describing the cytologic features of this rather uncommon morphologic variant of pancreatic adenocarcinoma. Recognition of this morphologic variant of pancreatic adenocarcinoma in ESU-FNA samples allows its differentiation from primary and metastatic signet-ring cell carcinomas.

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Section: Discussionmentioning

confidence: 99%

Cytologic features of pancreatic adenocarcinoma with “vacuolated cell pattern.” report of a case diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration

Samad

Conway

Attam

et al. 2014

Diagnostic Cytopathology

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“…Artefactual changes can mimic signet cell carcinoma 2,6 and benign signet cell proliferations mimicking signet ring carcinoma have been reported in the prostate 7 and endometrium 8 . Conversely, a case of signet ring adenocarcinoma metastatic to the bronchus mimicking goblet cell hyperplasia has been reported 9 …”

Section: Commentmentioning

confidence: 99%

Isolated intramucosal goblet cells in subacute ischaemic enteritis: mimicry of signet ring cell carcinoma

et al. 2005

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Nonneoplastic Lesions

Kini¹

2002

Color Atlas of Pulmonary Cytopathology

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Nonneoplastic LesionsThe topic of nonneoplastic lesions of the lower respiratory tract (tracheobronchial tree and lungs) is very broad, encompassing myriads of etiologically diverse disease processes with equally diverse morphologic changes in the tissues. The morphologic evidence of tissue damage is not always reflected in the cytological specimens from the respiratory tract and, when detected, may not be evident in all types of respiratory specimens.The subject of nonneoplastic lung disorders is so broad that many textbooks have been devoted to pulmonary diseases in general and to individual disease processes. A detailed discussion is beyond the scope of this atlas. Only those disease processes that demonstrate cellular alterations in cytological specimens from the respiratory tract will be discussed in this chapter. SECTION I NONNEOPLASTIC EPITHELIAL CHANGES Morphologie Alterations of BronchiallBronchiolar EpitheliumThe epitheliallining cells of the tracheobronchial tree and alveoli exhibit a wide array of morphologic changes in response to various types of insults or injuries, such as infectious agents or mechanical trauma (e.g., instrumentation, smoking, environmental toxins, dust, immunological diseases, radiation, drugs, etc.). The resulting changes may be mild and reversible, or severe and abnormal enough as to mimic neoplasia, causing a great potential for diagnostic errors. The extent of cytomorphologic alterations is dependent on the type of cell injury or the etiologic agent, the intensity and the duration of the injury, the anatomic site, and, most important, the immune status of the host. The cellular changes can be specific and pathognomonic of the disease process or nonspecific (e.g., proliferative/hyperplastic, repair/regenerative, and degenerative with or without cell death). Overlap of such various cytopathologic fea-38

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Signet Ring Adenocarcinoma Metastatic to the Bronchus and Mimicking Goblet Cell Hyperplasia

Cited by 5 publications

References 20 publications

Cytologic features of pancreatic adenocarcinoma with “vacuolated cell pattern.” report of a case diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration

Cytologic features of pancreatic adenocarcinoma with “vacuolated cell pattern.” report of a case diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration

Isolated intramucosal goblet cells in subacute ischaemic enteritis: mimicry of signet ring cell carcinoma

Nonneoplastic Lesions

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