PMC3350062_01
Clinical photograph of the patient showing multiple atypical neurofibromas of left lower limb (shown by arrow).
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fig1
Patient developed gradually progressive swellings over left calf involving the whole of leg below knee joint up to the ankle, with reddish brown discoloration of overlying skin (Figure 1).
Chest radiograph showing osteosclerotic metastatic lesions in the upper end of humerus (white arrow).
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fig2
Chest radiograph revealed old healed pulmonary tuberculosis of left upper lobe with osteosclerotic metastasis to humerus (Figure 2).
Bone marrow aspirate showing cells with round to oval nuclei and abundant pale eosinophilic and vacuolated cytoplasm.
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fig3
Bone marrow aspirate revealed cells with round to oval nuclei, fine granular chromatin with single large central prominent nucleoli and abundant pale eosinophilic to vacuolated cytoplasm with acini formation suggestive of adenocarcinoma (Figures 3(a) and 3(b)).
(100x) CSF cytology showing large cells with high nuclear to cytoplasmic ratio. Malignant cell shown by arrow.
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fig4
CSF examination for malignant cytology showed large cells with high nucleus to cytoplasm ratio suggestive of malignant cells (Figure 4). 
Histopathological examination of ulceroinfiltrative growth of stomach showing malignant signet ring cell and significant dysplasia and altered gland morphology.
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fig5
Histopathological study of biopsy specimen of the growth revealed poorly differentiated adenocarcinoma with architectural disarray and signet-ring cells (Figures 5(a) and 5(b)) which are characteristic finding of diffuse variety of adenocarcinoma stomach.