scholarly journals Diagnosis of malignant effusion using cell block and immunohistochemistry

2019 ◽  
Vol 7 (9) ◽  
pp. 3556
Author(s):  
Bhavna Gamit ◽  
Deepshikha Dave ◽  
Neha Shahu
Keyword(s):  
Carcinoembryonic Antigen ◽  
Epithelial Membrane Antigen ◽  
Early Stage ◽  
Abdominal Distension ◽  
Mesothelial Cells ◽  
Cell Block ◽  
Malignant Effusion ◽  
Adenocarcinoma Cells ◽  
Signet Ring ◽  
Atypical Cells

The distinction between reactive mesothelial and adenocarcinoma cells specially signet ring type in serous effusions may be very difficult based only on morphological features particularly in early stage. Reactive mesothelial cells show varying degree of cytological atypia hence posing difficulty in differentiating it from adenocarcinoma cells. We report a case of 45 year old female patient presented with abdominal distension. Patient was an operated case of adenocarcinoma of stomach. Smears prepared from ascitic fluid and cell block shows large number of reactive mesothelial cells and few atypical cells. Atypical cells were immunoreactive for cytokeratin, epithelial membrane antigen and carcinoembryonic antigen. These confirmed the presence of malignant epithelial cells so we reported it as a malignant effusion.

scholarly journals Epithelial Membrane Antigen, Vimentin, Desmin, Calretinin, E-Cadherin on Cell Block Preparations to Distinguish Well Differentiated Adenocarcinoma from Benign, Reactive, Atypical Mesothelial Cells

2021 ◽  
Vol 10 (18) ◽  
pp. 1302-1308
Author(s):  
Neha Jaiswal ◽  
Jayant Makrande ◽  
Sunita Vagha
Keyword(s):  
Epithelial Membrane Antigen ◽  
Mesothelial Cells ◽  
Definitive Diagnosis ◽  
Cytological Diagnosis ◽  
Cell Block ◽  
Malignant Cells ◽  
Immunohistochemical Markers ◽  
Adenocarcinoma Cells ◽  
Well Differentiated ◽  
E Cadherin

BACKGROUND Inconclusive cytomorphology often results due to failure to distinguish between adenocarcinoma cells from benign, reactive, atypical mesothelial cells in effusion specimens. To resolve such dilemmas, auxiliary techniques like immunohistochemistry were utilised to reach a definitive diagnosis for better treatment and management of patients. We wanted to compare cytodiagnosis achieved on cell block preparations with the cytodiagnosis on conventional smear and perform immunohistochemistry for epithelial membrane antigen (EMA), calretinin, desmin, vimentin and E-cadherin on cell block preparation of the fluids in cases of indistinguishable cytomorphology of adenocarcinoma and reactive, atypical, and benign mesothelial hyperplasia. METHODS The immunohistochemical markers namely EMA, calretinin, vimentin, desmin and Ecadherin were applied on cell blocks employing streptavidin-biotin method. Immunohistochemistry was interpreted by giving scores to the percentage of stained cells. RESULTS EMA and E-cadherin had 100 % sensitivity in diagnosing adenocarcinoma whereas calretinin, vimentin and desmin were 100 % sensitive in diagnosing reactive, atypical mesothelial carcinoma on the cell block preparations. CONCLUSIONS Immunocytochemistry of fluid should be carried out on the cell block preparation where cytological diagnosis on conventional smear and cell block fails to detect malignant cells in the preparation. KEY WORDS Cell Block, Adenocarcinoma, Mesothelial Cells, Immunohistochemistry, EMA, Calretinin, Vimentin, Desmin, E-Cadherin

scholarly journals Deciduoid Mesothelioma of Peritoneum Masquerading as Peritoneal Carcinomatosis.

2021 ◽  
Author(s):  
Jyotsna Naresh Bharti ◽  
Jeewan Ram Vishnoi
Keyword(s):  
Pleural Cavity ◽  
Subcutaneous Fat ◽  
Abdominal Distension ◽  
Axial Skeleton ◽  
Mesothelial Cells ◽  
Lower Limbs ◽  
Tunica Vaginalis ◽  
Ki 67 ◽  
Atypical Cells ◽  
Cd 68

Abstract Mesothelioma is an insidious neoplasm that develops from mesothelial cells. About 80 % of mesotheliomas originate in the pleural cavity. Other sites where it has been reported are the peritoneal cavity, tunica vaginalis, and the pericardium. A 45-year-old female presented with complaints of abdominal distention and pain for three months. Physical examination revealed signs of wasting of the appendicular and axial skeleton muscles, loss of subcutaneous fat, and hollowing of the eye sockets. There was pitting edema in the bilateral lower limbs. Per abdomen, examination revealed abdominal distension with umbilicus in the midline. On palpation, gross ascites was present, and no organomegaly, definitive mass, or lump was palpable. On percussion, the dull note was heard all over the abdomen, and fluid thrill was appreciated. The ascitic fluid examination revealed the presence of atypical cells. Omentectomy was done and sent for histopathological examination.The specimen of omentectomy was in multiple fragments and measured 17x16x3cm. Few of the fragments were nodular, soft to firm. On serial slicing, the cut section was gray-white with areas of necrosis. Microscopic examination showed sheets of malignant cells. These tumor cells were immunoreactive to EMA, Cytokeratin, Vimentin, Calretinin, WT-1, and D2-40 and immunonegative to Desmin (highlighting only the entrapped reactive mesothelial cells), Inhibin, BerEP4, TTF-1, CD 68, Napsin, ER, CEA, CDX2, PR, PAX-8, and SALL4. Ki 67 labelling index was 15%. The features were of Malignant Mesothelioma, Deciduoid variant. Deciduoid mesothelioma is a rare subtype with a poor prognosis. So, the mesothelioma should be distinguished from deciduosis.

scholarly journals Atypical Granulomatosis with Polyangiitis Presenting with Meibomitis, Scleritis, Uveitis and Papillary Bladder Tumor: A Case Report and Literature Review

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 680
Author(s):  
Takashi Kojima ◽  
Murat Dogru ◽  
Eisuke Shimizu ◽  
Hiroyuki Yazu ◽  
Aya Takahashi ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Early Stage ◽  
Topical Steroid ◽  
Granulomatous Inflammation ◽  
Oral Prednisolone ◽  
Meibomian Gland ◽  
Clinical Findings ◽  
Meibomian Gland Dysfunction ◽  
Oral Steroids ◽  
Atypical Cells

Granulomatosis with polyangiitis (GPA) presents with a variety of systemic findings, sometimes with ocular findings initially, but is often difficult to diagnose at an early stage. An 85-year-old male had complaints of ocular dryness and redness and was diagnosed with meibomian gland dysfunction with meibomitis. Despite an initial treatment with topical steroid and antibiotics, the meibomitis did not improve and the left eye developed scleritis and iridocyclitis. The patient was administered topical mydriatics and oral steroids. During follow-up, the patient developed left hearing difficulty and reported a darker urine. Urinalysis revealed microscopic hematuria. A blood test showed an elevated erythrocyte sedimentation rate, positivity for perinuclear anti-neutorophil cytoplasmic antibody, and elevations in blood urea nitrogen and serum creatinine. Nasal mucosal biopsy showed a non-necrotizing granulomatous inflammation. Renal biopsy revealed focal glomerulosclerosis. Cystoscopy and bladder wash followed by a planned transurethral resection revealed atypical cells and apical papillary tumors which were resected. Iridocyclitis and scleritis responded well to oral prednisolone with 0.1% topical betamethasone and prednisolone ointment. The patient is tumor free with no recurrences 24 months after resection. GPA may present atypically with meibomian gland dysfunction without showing representative clinical findings. Early detection and treatment are essential for visual recovery.

scholarly journals Signet-Ring Cell Carcinoma of the Colon: A Case Report and Review of the Literature

2015 ◽  
Vol 8 (3) ◽  
pp. 466-471 ◽  
Author(s):  
Peter Y. Park ◽  
Teresa Goldin ◽  
John Chang ◽  
Maurie Markman ◽  
Madappa N. Kundranda
Keyword(s):  
Cell Carcinoma ◽  
Early Stage ◽  
Single Agent ◽  
The United States ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Early Stage Disease ◽  
Lower Quadrant ◽  
Signet Ring ◽  
Ring Cell

Background: Colorectal adenocarcinoma (CRC) is the third leading cause of death in the United States. One of the histologic subtypes of CRC is signet-ring cell carcinoma (SRCC), which has a distinct molecular and tumor biology from that of adenocarcinoma. Primary SRCC diagnosed at an early stage is very rare as most cases are detected at an advanced stage. Therefore, overall prognosis of SRCC is poor. Case Presentation: A 36-year-old female presented to her primary care physician with new-onset progressive right lower quadrant pain without any significant past medical or family history. Computed tomography scan of the abdomen and pelvis with contrast showed a 4.9 × 3.5 × 3.1 cm, lobulated, septated cystic mass arising from the cecum. The mass demonstrated wall enhancement and contained focal areas of coarse calcification. There was nodal involvement either locally or distally. The patient underwent right hemicolectomy, and pathology revealed a high-grade mucinous carcinoma with signet-ring cell variant invading through the muscularis propria and into the subserosal adipose tissue. The margins were negative for tumor, and no lymphovascular or perineural invasion was noted. None of the 14 resected pericolonic lymph nodes was positive for malignancy. Hence, she was staged as pT3, pN0, pMx-stage IIA. The appendix was not involved. Microsatellite instability testing showed the preservation of MLH1, PMS2, MSH2 and MSH6 proteins by IHC and PCR. Carcinoembryonic antigen level was within normal limits. Due to the patient's young age, aggressive histology and microsatellite-stable status, adjuvant fluropyrimidine (5-FU)-based therapy with the single agent capecitabine was initiated. The patient completed 6 months of adjuvant therapy and has been disease free for approximately 18 months. Conclusion: Primary SRCC of the cecum is a rare disease. Given the poor prognosis of these patients, early-stage disease with microsatellite-stable patients should be considered for adjuvant 5-FU-based therapy in an attempt to prevent recurrence.

Primary signet ring cell histology does not portend worse survival for early stage lung cancer following lobectomy

2021 ◽  
pp. 021849232110459
Author(s):  
Terrance Peng ◽  
Anita Yau ◽  
Li Ding ◽  
Elizabeth A. David ◽  
Sean C. Wightman ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Signet Ring Cell ◽  
Rank Test ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Increased Risk ◽  
Signet Ring ◽  
Ring Cell ◽  
The Impact

Introduction Signet ring cell (SRC) histology is considered a poor prognostic factor in various cancers. However, primary SRC lung adenocarcinoma is rare and poorly understood. Methods The National Cancer Database was queried to identify treatment-naïve patients who received lobectomy for primary SRC or non-SRC pT1-2N0 lung adenocarcinoma <4 cm within four months of diagnosis. SRC lung adenocarcinoma was defined by ICD-O-3 code 8490, while non-SRC lung adenocarcinoma was defined by ICD-O-3 codes 8140, 8141, 8143, 8147, 8255, 8260, 8310, 8481, 8560, and 8570–8574. The Kaplan-Meier curve and log-rank test was used to compare five-year OS between SRC versus non-SRC lung adenocarcinoma cohorts. The impact of SRC histology on risk of death was assessed using the Cox proportional hazards regression model. Results 48,399 patients were included in this study: 62 with primary SRC lung adenocarcinoma and 48,337 with non-SRC lung adenocarcinoma. The mean age of the overall cohort was 67.0 ± 9.6 years. Five-year OS following lobectomy did not differ significantly between SRC lung adenocarcinoma and non-SRC lung adenocarcinoma cohorts (SRC 73.9% vs. non-SRC 69.3%, p = 0.64). SRC histology did not significantly impact risk of death within five years after lobectomy (HR 0.89, p = 0.66). Conclusions Following lobectomy for pT1-2N0 tumors <4 cm, patients with primary SRC lung adenocarcinoma do not experience worse five-year OS or increased risk of death within five years relative to those with non-SRC lung adenocarcinoma. Additional study, including exploration of emerging molecular profiling data, may serve to better define optimal treatment for this histopathologic group of lung adenocarcinomas.

scholarly journals miR-9 Does Not Regulate Lamin A Expression in Metastatic Cells from Lung Adenocarcinoma

2020 ◽  
Vol 21 (5) ◽  
pp. 1599
Author(s):  
Julien Guinde ◽  
Audrey Benoit ◽  
Diane Frankel ◽  
Stéphane Robert ◽  
Kevin Ostacolo ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Cell Sorting ◽  
Epithelial Membrane Antigen ◽  
Carcinoma Cells ◽  
Lamin A ◽  
Neural Cells ◽  
Metastatic Cells ◽  
Adenocarcinoma Cells ◽  
Metastatic Process ◽  
Central Actor

In lung adenocarcinoma, low lamin A expression in pleural metastatic cells has been proposed as a pejorative factor. miR-9 physiologically inhibits the expression of lamin A in neural cells and seems to be a central actor in the carcinogenesis and the metastatic process in lung cancer. Thus, it could be a good candidate to explain the reduction of lamin A expression in lung adenocarcinoma cells. miR-9 expression was analyzed in 16 pleural effusions containing metastatic cells from lung adenocarcinoma and was significantly reduced in patients from the ‘Low lamin A expression’ group compared to patients from the ‘High lamin A expression’ group. Then, carcinoma cells selection by fluorescence-activated cell sorting (FACS) was performed according to epithelial membrane antigen (EMA) expression, reflecting lamin A expression. miR-9 was underexpressed in lamin A− carcinoma cells compared to lamin A+ carcinoma cells in patients from the ‘Low lamin A expression’ group, whereas there was no difference of miR-9 expression between lamin A+ and lamin A− carcinoma cells in patients from the ‘High lamin A expression’ group. These results suggest that miR-9 does not regulate lamin A expression in metastatic cells from lung adenocarcinoma. On the contrary, miR-9 expression was shown to be reduced in lamin A-negative carcinoma cells.

Early-stage primary signet ring cell carcinoma of the colon with magnifying endoscopic findings

2019 ◽  
Vol 90 (3) ◽  
pp. 529-531
Author(s):  
Tatsunori Minamide ◽  
Kensuke Shinmura ◽  
Hiroaki Ikematsu ◽  
Tomonori Yano
Keyword(s):  
Cell Carcinoma ◽  
Early Stage ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Carcinoma Of The Colon ◽  
Endoscopic Findings ◽  
Signet Ring ◽  
Ring Cell
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