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- 三院100420胃活检(朱本院201003451).够癌吗?急!谢谢!
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These cells look like signet ring cells. But two things are holding me off: 1) signet ring cell carcinoma usually presents as infiltrating tumor cells causing diffuse thickening of gastric walls (所谓皮革胃），not as distinct small polyps. 2)adjcent glands and surface epithelium are perfectly benign/unremarkable, not even the mildest atypia/dysplasia.
I have seen cases of abundant foamy histiocytes accumulation in stomach presented as polyps, simillar to xantholesma in eyelides, it is called xanthomatous gastritis. I would do pan CK and CD68 to differentiate these two entirely different diseases.
| 以下是引用mingfuyu在2010-4-14 9:45:00的发言：
These cells look like signet ring cells. But two things are holding me off: 1) signet ring cell carcinoma usually presents as infiltrating tumor cells causing diffuse thickening of gastric walls (所谓皮革胃），not as distinct small polyps. 2)adjcent glands and surface epithelium are perfectly benign/unremarkable, not even the mildest atypia/dysplasia. I have seen cases of abundant foamy histiocytes accumulation in stomach presented as polyps, simillar to xantholesma in eyelides, it is called xanthomatous gastritis. I would do pan CK and CD68 to differentiate these two entirely different diseases. 译:这些细胞看上去象印戒细胞.但两件事件让我不放心:1)印戒细胞癌通常表现为浸润性肿瘤细胞,故引起胃壁弥漫性增厚(所谓皮革胃),不表现为明显的小息肉.2)附近的腺体和表面的上皮表现为很非常的良性/无明显的异型,甚至也无轻微的不典型增生/异型增生. 我已看过大量泡沫样组织细胞积聚呈息肉改变的病例,相似于眼睑的黄色瘤,这叫做黄色肉芽肿型胃炎.我将做广谱的CK和CD68来区别这二者完全不同的疾病. THANKS FOR YOUR BRILLIANT VIEW! |
朱正龙
| 以下是引用mingfuyu在2010-4-14 9:45:00的发言：
These cells look like signet ring cells. But two things are holding me off: 1) signet ring cell carcinoma usually presents as infiltrating tumor cells causing diffuse thickening of gastric walls (所谓皮革胃），not as distinct small polyps. 2)adjcent glands and surface epithelium are perfectly benign/unremarkable, not even the mildest atypia/dysplasia. I have seen cases of abundant foamy histiocytes accumulation in stomach presented as polyps, simillar to xantholesma in eyelides, it is called xanthomatous gastritis. I would do pan CK and CD68 to differentiate these two entirely different diseases. |
It should be relatively easy to differentiate "signet ring" adenocarcinomatous cells from xanthomatous cells based on morphology in most of the cases. I would say that you do not really need to struggle in this particular case. Another point: the signet ring cell carcinoma is presumably arising from dysplasia of the neck region of the gastric glands ( so called globoid dysplasia), thus you usually do not see glandular dysplasia in the vicinity of the carcinoma, like you see in cases of carcinoma of the intestinal type.
