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Question:
Base on initial image, what type of cells could these be in the stroma?
Base on initial image, what type of cells could these be in the stroma?
PASD
Pancytokeratin
CK7/CK20
CDX2
Question:
Based on the limited immunohistochemistry supplied, what type of signet-ring carcinoma would you favour?
Based on the limited immunohistochemistry supplied, what type of signet-ring carcinoma would you favour?
ER 
PAX-8
PAX-8
Diagnosis:
Metastatic gastric adenocarcinoma (signet ring cell carcinoma)(Patient had a past Hx of gastric carcinoma).
#GIpath
(Colleagues case)
Question
Which of the following organs is more likely to have is metastasis?
Which of the following organs is more likely to have is metastasis?
1/ Metastatic disease to the cervix and uterus is uncommon, with the more common sites being the ovary or vagina.
2/ Direct spread of an endometrial carcinoma is more common than metastatic disease in the cervix https://pubmed.ncbi.nlm.nih.gov/29750707/
2/ Direct spread of an endometrial carcinoma is more common than metastatic disease in the cervix https://pubmed.ncbi.nlm.nih.gov/29750707/
True or false?
CDX-2 can be positive in endocervical carcinomas but not in endometrioid carcinomas.
CDX-2 can be positive in endocervical carcinomas but not in endometrioid carcinomas.
3/ CDX-2 is a transcription factor that is important in the development of the intestinal tract.
4/ Other tumours shown to occasional express it are endometrioid, ovarian mucinous and endocervical* carcinomas.
*(not limited to gastric type) https://pubmed.ncbi.nlm.nih.gov/18753946/
4/ Other tumours shown to occasional express it are endometrioid, ovarian mucinous and endocervical* carcinomas.
*(not limited to gastric type) https://pubmed.ncbi.nlm.nih.gov/18753946/
True or false?
PASD is useful in telling muciphages from signet-ring cells.
PASD is useful in telling muciphages from signet-ring cells.
5/ As much as it pains me to say, PASD is of limited value here as muciphages can be positive (hints in the name!).
6/ Little bit off topic, but signet-ring cell change (i.e. benign change) in the stomach can be confused with gastric ca https://pubmed.ncbi.nlm.nih.gov/15252323/
6/ Little bit off topic, but signet-ring cell change (i.e. benign change) in the stomach can be confused with gastric ca https://pubmed.ncbi.nlm.nih.gov/15252323/
True or false?
Lastly, primary signet ring carcinoma of the cervix is MORE COMMON that a deposit of metastatic gastric carcinoma?
Lastly, primary signet ring carcinoma of the cervix is MORE COMMON that a deposit of metastatic gastric carcinoma?
7/ Primary signet-ring cell carcinoma of the cervix is very rare, with metastasis from a primary gastric tumour being more likely (still rare though).
8/ Care needs to be taken as CDX-2 and CK20 can be positive in both.
9/ History is super important. https://pubmed.ncbi.nlm.nih.gov/20173504/
8/ Care needs to be taken as CDX-2 and CK20 can be positive in both.
9/ History is super important. https://pubmed.ncbi.nlm.nih.gov/20173504/
