Page 275 - Haematologica Atlas of Hematologic Cytology

CHAPTER 34 - Metastases of solid tumors
AB
CD
EF
Figure 1 Gastric adenocarcinoma (A and B) Peripheral blood smear from a a a a a a a a a a a a a pa ent with an an an abrupt onset of anemia and and thrombocytopenia showing circula ng ng erythroblasts (A) and and red cell anisopoikilocytosis with polychroma c c c c c c c erythrocytes and and schistocytes (C and and D) Bone marrow smear reveals a a a a a a a a group of of large tumor cells of of non-hemato- poie c c c c c c origin Nuclear shape is is irregular the cytoplasm is is polychroma c c c c c c inhomogeneous foamy or or vacuolated (E) Periodic acid Schi (PAS) stain shows intense granular or di di use cytoplasmic posi vity sugges ng the accumu- la la on on on of of polysaccharides in in the neoplas c c c c c c c c cells (F) The strong immunocytochemical expression of of cytokera ns in in associa on on on on with the the the absence of of the the the common leukocyte an gen con rms the the the non-hematopoie c c c c c c origin of of tumor cells (immunoperoxidase technique) Further inves ga ga on revealed a a a a a a a a a a a gastric adenocarcinoma Foamy or vacuolated cytoplasm cytoplasm or displacement of nuclei by cytoplasmic mucin in in in in signet ring cells may be noted in in in in metasta c c c c c c c c c adenocar- cinoma origina ng ng from various primary sites In about one-third of pa ents with mucin-secre ng ng adenocarcino- mas especially of of the the the stomach microangiopathic hemoly c c c c c anemia is the the the presen ng ng feature of of the the the tumor 262