PMC5964560_01
Dystrophic adipocytes mimicking metastatic signet ring cell adenocarcinoma in a cachectic patient. (a) Moderately differentiated adenocarcinoma invading externally into the colon at the splenic flexure with associated colonic stricture, ulceration, and mural fibrosis (hematoxylin-eosin stain, x200). (b, c) The pericolonic tissue, mesentery, subserosa, and lymph nodes demonstrated signet ring-like cells that showed variation in size with a thickened cell membrane (hematoxylin-eosin stain, (b) x100, (c) x400). (d) Pericolonic lymph node demonstrated signet ring-like cells mimicking the appearance of metastatic involvement (hematoxylin-eosin stain, x100). (e, f) Immunohistochemical staining of the signet ring-like cells demonstrates these cells to be negative for AE1/AE3 staining ((e) x400), while being positive for S-100 staining ((f) x400).
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Histologic examination demonstrated a moderately differentiated adenocarcinoma invading externally into the colon at the splenic flexure with associated colonic stricture, ulceration, and mural fibrosis (Figure 1(a)). The pericolonic tissue, mesentery, subserosa, and lymph nodes demonstrated signet ring-like cells without typical adipocytes (Figures 1(b) and 1(c)). Additionally, one pericolonic lymph node demonstrated signet ring-like cells mimicking the appearance of metastatic involvement (Figure 1(d)).