Morphology and pathogenesis of Liesegang rings in cyst aspirates: report of two cases with ancillary studies.
Liesegang rings are laminated ring-like structures occasionally found in benign cysts and abscesses. They have been confused with parasites (especially eggs), algae, calcifications, and psammoma bodies. We examined Liesegang rings from fine-needle aspiration (FNA) biopsies of a benign cyst of the breast and a complex renal cyst. Liesegang rings were best observed with Papanicolaou, hematoxylin-eosin, Masson's trichrome, acid-fast (AFB), and Gram stains, which accentuate the concentrically laminated morphology. An amorphous electron-dense core and fibrillary lucent concentric rings were seen with transmission electron microscopy with no significant energy peaks by electron probe microanalysis or distinct diffraction patterns by X-ray diffraction. This investigation indicates that Liesegang rings are composed of organic substances most likely formed by periodic precipitation from a supersaturated solution within cystic fluid. Awareness of the Liesegang phenomenon within cystic lesions will decrease the possibility of erroneous misdiagnosis as another type of pathologic process.
Department of Pathology, East Carolina University School of Medicine, Greenville, USA.
D S
DS
Raso
W B
WB
Greene
J L
JL
Finley
J F
JF
Silverman
D020420:Cyst Fluid / Q000737:chemistry; D005260:Female; D005348:Fibrocystic Breast Disease / Q000473:pathology*; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000473:pathology*; D008875:Middle Aged