脂肪细胞萎缩模拟胆囊印戒细胞癌。

IF 0.7 Q4 PATHOLOGY Case Reports in Pathology Pub Date : 2021-10-31 eCollection Date: 2021-01-01 DOI:10.1155/2021/4676885
Benjamin van Haeringen, Leo Francis, Emily Olive, Daniel James
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引用次数: 0

摘要

印戒细胞形态可能由多种原因引起,其范围从良性反应现象到高度侵袭性恶性肿瘤的指示。良性上皮印戒细胞的改变在多种组织中都有很好的描述,但非上皮印戒细胞的改变是一种罕见的脂肪组织形态适应,主要在恶病质的情况下描述。这些萎缩性脂肪细胞位于正常上皮层平面外可能引起对侵袭性或转移性恶性肿瘤的关注,考虑良性反应过程对于避免灾难性的过度诊断和过度治疗至关重要。此外,这种变化本身与潜在恶病质相关的显著死亡率有关,可能对治疗临床医生很重要。与恶性印戒细胞癌相比,良性印戒细胞改变更可能保留正常的分叶结构,不形成肿块,缺乏明显的异型性,粘液样基质,毛细血管网络突出,S100蛋白阳性,细胞角蛋白和粘蛋白阴性。据我们所知,我们报告了第一例涉及胆囊的非上皮性印戒细胞改变,这是在一位老年恶病质男性的常规胆囊切除术后偶然发现的。
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Adipocyte Atrophy Mimicking Signet Ring Cell Carcinoma of the Gallbladder.

Signet ring cell morphology may result from a variety of causes and ranges from a benign reactive phenomenon to being indicative of highly aggressive malignancy. Benign epithelial signet ring cell change is well described in a variety of tissues, but nonepithelial signet ring cell change is a rare morphologic adaptation of adipose tissue principally described in the setting of cachexia. The location of these atrophic adipocytes outside the plane of normal epithelial layers may raise concern for invasive or metastatic malignancy, and consideration of a benign reactive process is critical to avoid catastrophic overdiagnosis and overtreatment. Further, this change is itself associated with significant mortality related to the underlying cachexia and may be important to highlight to treating clinicians. Compared to malignant signet ring cell carcinoma, benign signet ring cell change is more likely to retain normal lobulated architecture without mass formation, lack significant atypia, have myxoid stroma with a prominent capillary network, and show positive staining S100 protein with negative staining for cytokeratins and mucin. To our knowledge, we present the first described case of nonepithelial signet ring cell change involving the gallbladder, detected as an incidental finding following routine cholecystectomy in an elderly cachectic man.

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审稿时长
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