ISSN: 2161-0681

Journal of Clinical & Experimental Pathology
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  • Case Report   
  • J Clin Exp Pathol 2014, Vol 4(1): 155
  • DOI: 10.4172/2161-0681.1000155

Pure Signet-ring Cell Carcinoma of Lung by Fine Needle Aspiration in a Smoking Asian American: Case Report and Literature Review

Rajkumar A1, Li J2, D’Cruz C1, Patel K3, Patel P3, Elreda L4 and Wang H5*
1Department of Pathology, Newark Beth Israel Medical Center, Newark, NJ 07112, USA
2Department of Pathology, China Medical University, Shenyang, 110001, China
3Department of Medicine, Newark Beth Israel Medical Center, Newark, NJ 07112, USA
4Cohen Cancer Center, Newark Beth Israel Medical Center, Newark, NJ 07112, USA
5Department of Pathology and Lab Medicine, Temple University, Philadelphia, PA 19140, USA
*Corresponding Author : Wang H MD, PhD, Assistant Professor, Department of Pathology and Lab Medicine, Temple University, Philadelphia, PA 19140, USA, Tel: 215-707-3707, Fax: 267-355-4250, Email: he.wang@tuhs.temple.edu

Received Date: Oct 12, 2013 / Accepted Date: Dec 27, 2013 / Published Date: Dec 30, 2013

Abstract

Pure primary Signet-Ring Cell Carcinoma (SRCC) of lung is an extremely rare entity. Typically seen in nonsmokers, it is considered to be highly invasive, highly aggressive and carries a worse prognosis when compared to other types of lung tumors. Cytological identification of pulmonary SRCC is challenging and must be differentiated from both benign and malignant lesions. Here we describe a case of a 40-year-old immigrant Chinese male with a significant past medical history of smoking, who was found to have 2.7 cm lung nodule on CT scan. A subsequent CT scan two weeks later showed the original right lung nodule with no evidence of extra pulmonary lesions on the PET scan and the bone scan. Bronchoalveolar lavage and brushings, as well as fine needle aspiration, of the lung lesion revealed an adenocarcinoma with 100% signet ring cell morphology. Due to the lack of extra pulmonary malignancy according to radiographic evidence, the following immunocytochemistry work up on the cell block was performed in order to characterize the lesion as primary pulmonary SRCC: CK7, CK20, TTF-1, p63, CDX2, thyroglobulin, CD68, napsin A, PSA and PSAP. Subsequent excision biopsy was obtained, which revealed adenocarcinoma with 95% signet ring cell purity.

Keywords: Signet Ring Cell Adenocarcinoma; Lung; Cytomorphology; Immunohistochemistry

Citation: Rajkumar A, Li J, D’Cruz C, Patel K, Patel P, et al. (2013) Pure Signet-ring Cell Carcinoma of Lung by Fine Needle Aspiration in a Smoking Asian American: Case Report and Literature Review. J Clin Exp Pathol 4:155. Doi: 10.4172/2161-0681.1000155

Copyright: © 2013 Rajkumar A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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