An Epithelioid Smooth Muscle Neoplasm Mimicking a Signet Ring Cell Carcinoma in the Ovary

A Case of Prostatic Signet-Ring Cell-like Carcinoma with Pagetoid Spread and Intraductal Carcinoma and Long-Term Survival: PD-L1 and Mismatch Repair System Proteins (MMR) Immunohistochemical Evaluation with Systematic Literature Review

Prostatic adenocarcinoma (PA) is the second most common malignancy in men globally. Signet-ring cell-like adenocarcinoma (SRCC) is a very rare PA subtype, with around 200 cases reported in the English literature. Histologically, the tumor cells show a vacuole compressing the nucleus to the periphery. Pagetoid spread in acini and ducts is usually related to metastases from urothelial or colorectal carcinomas, less commonly associated with intraductal carcinoma (IC); histologically, the tumor cells grow between the acinar secretory and basal cell layers. To our knowledge, we report the first prostatic SRCC (Gleason score 10, stage pT3b) associated with IC and pagetoid spread to prostatic acini and seminal vesicles. To our systematic literature review (PRISMA guidelines), it is the first tested case for both PD-L1 (<1% of positive tumor cells, clone 22C3) and mismatch repair system proteins (MMR) (MLH1+/MSH2+/PMS2+/MSH6+). We found no SRCC previously tested for MMR, while only four previous cases showed high expression of another PD-L1 clone (28-8). Finally, we discussed the differential diagnoses of prostatic SRCC.

Natural evolvement of lung tumors induced by N-ethyl-N-nitrosourea (ENU) and the impact of a high sucrose-high fat diet on tumor evolvement assessed by tumor histology in inbred BALB/c and C57BL/6J mice

Background

The model of lung tumors transplacentally induced by N-ethyl-N-nitrosourea (ENU) in inbred BALB/c and C57BL/6J mice was used to investigate the impact of a high sucrose-high fat (HSHF) diet on lung tumorigenesis.

Methods

The offspring was separated by gender and randomly divided into 2 subgroups in both ENU- and buffer-treated groups at the time of weaning. One subgroup was put on the standard diet and the other on the HSHF diet from weaning to the age of 24 weeks. The entire lungs went through a standard process of paraffin-embedded blocks. Every lung block was cut in serial sections but one in every five sections was saved to generate step sections that were stained by hematoxylin and eosin. The tumor histology was assessed on the step sections.

Results

At 24-week checkpoint, a spectrum of histological changes was observed in the mice on both diets. Specifically, they presented as alveolar hyperplasia, adenomas and adenomas with nuclear dysplasia at various degrees. Those tumors were actually at different developmental stages. Lung adenocarcinomas were developed in mice on the HSHF diet. A cluster of tumor cells with wide foamy or clear or signet-ring shaped cytoplasm (fatty changes) appeared in a low frequency on the HSHF diet.

Conclusions

The observed histological changes indicated that lung tumors were developed at different times and evolved at different paces. The HSHF diet accelerated the course of tumor evolvement. Tumor cells with fatty changes might be induced by the HSHF diet.