Case 2 -

Metastatic Mucinous Adenocarcinoma with Focal Signet Ring Cell Differentiation Brigitte Ronnett The Johns Hopkins Hospital Baltimore, MD

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Click here to download handout in 1-up pdf format for the current section (4.84 MB) Click here to download handout in 6-up pdf format for the current section (1.42 MB) Clinical History 36 year old woman ~7 weeks status post C-section (ovaries, cervix, and omentum described as normal at delivery) with a hypercoagulable state. In addition there are bilateral lower extremity deep vein thromboses complicated by pulmonary embolism. Enlarged supraclavicular and cervical lymph nodes were found and a biopsy of a cervical lymph node was performed (Images only). Case 2 - Figure 1 - Scanning power image of the lymph node Case 2 - Figure 2 - Higher magnification showing multiple cystic spaces Case 2 - Figure 3 - Replacement of node parenchyma Case 2 - Figure 4 - Higher magnification of malignant glands Case 2 - Figure 5 - Solid and glandular growth patterns Case 2 - Figure 6 - Well demarcated gland surrounded by solid growth Case 2 - Figure 7 - Solid growth (center) merging with signet ring cells (left) Case 2 - Figure 8 - Signet ring tumor cells