Histologic Changes

Another area of tumor shows the same vacuolated cells (left arrow) that were seen in the initial pleural cytology specimen from 1992. There is also microgland formation. The vacuolated cells resemble "signet rings" with the nucleus pushed to the edge. The glands are lined by plump to flat cells. Some tumor cells grow in strands (right arrow) in the loose stroma.

What is the likely content of the vacuoles?

Answer

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What is the likely content of the vacuoles?

Answer: If this is an adenocarcinoma, they would contain neutral mucin. If this is a mesothelioma, they would contain acid mucin and stain with alcian blue.

This pattern of vacuoles and microglands resembles that of the benign adenomatoid tumor, which usually occurs in the genital tract, but has been described as a rare tumor of the pleura [1].

Reference:

1. Kaplan M, Tazelaar H, Hayashi T, Schroer K, Travis W. Adenomatoid tumors of the pleura. Am J Surg Pathol 1996; 20:1219-1223.

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