Gastric xanthoma: a diagnostic problem on brushing cytology smears.
OBJECTIVE
To describe the cytologic findings of gastric xanthomas and to compare them with the findings of signet-ring adenocarcinoma because atypical xanthoma cells can be easily confused with signet-ring adenocarcinoma cells.


METHODS
Five cases of gastric xanthoma that were confirmed by biopsy reports were selected for study. The patients' ages ranged between 50 and 58 years; 4 were men and 1 was a woman. Twenty-one cases of signet-ring adenocarcinoma confirmed by biopsy reports were selected for comparison. Special staining was performed.


RESULTS
The brushing cytology smears of the 5 cases of xanthoma revealed atypical cells, so initially they were reported as suspicious for signet-ring adenocarcinoma and biopsy examination advised. After learning of the histologic diagnosis of xanthoma, we performed special staining. The xanthoma cells were negative with periodic acid-Schiff (PAS) stain but showed a positive reaction with Oil red 0 and weakly positive reaction with Masson trichrome. Signet-ring adenocarcinoma cells showed a strongly positive reaction with PAS stain.


CONCLUSIONS
Gastric brushing cytology findings of xanthomas have not been described before. At times the differentiation of atypical xanthoma cells from signet-ring adenocarcinoma cells is very difficult on brushing cytology smears. In this study the nuclear changes and special stains helped differentiate the 2 lesions.
Kumar
Perikala V
PV
Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, I.R. Iran. kumarv@sums.ac.ir
Monabati
Ahmad
A
Naini
Mahvash Alizadeh
MA
Lankarani
Kamran Bagheri
KB
Fattahi
Mohammad Reza
MR
Asadilari
Maysam
M
D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013272:Stomach Diseases / Q000175:diagnosis* / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology; D014973:Xanthomatosis / Q000175:diagnosis* / Q000473:pathology