Histologic Changes

Look at the following two pictures, and answer the following questions.

A. This photo shows an H&E-stained section from the cell block of the first pleural fluid examination in 1992.

What are the large pink structures surrounded by cells?

What is the cell marked by the arrow?

What is the diagnosis?

Answers

B. This section was taken from the decortication in 1997.

 

Clinical summary Image 2

Table of Contents

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What are the large pink structures surrounded by cells? Answer: These could be large glands filled with secretion or papillary structures with a hyalinized core. Figure B suggests that the structures are papillae with cells left in some of the hyalinized cores. The epithelial cells covering the papillae are crowded and hyperchromatic, and have irregular shapes and increased N/C ratios, as do the surrounding cells. Mitoses are absent.

 

A.

What is the cell marked by the arrow?

Answer: This is a signet-ring cell, a cell with a cytoplasmic vacuole that compresses the nucleus to the periphery to resemble a signet ring.

What is the diagnosis?

Answer: These changes were diagnosed as malignant in the pleural fluid specimen from 1992, but subsequent pleural taps were nondiagnostic.

 

B.

In addition to confluent papillary structures, there is also a solid component of spindled cells, also considered to be malignant (lower right). Again, mitoses were rare even in this decortication specimen in 1997.

Clinical summary Image 2

Table of Contents