title: Gastric xanthoma: a diagnostic problem on brushing cytology smears.
abstract: 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.
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, I.R. Iran. kumarv@sums.ac.ir
authors.forename: Perikala V
authors.initials: PV
authors.lastname: Kumar
authors.forename: Ahmad
authors.initials: A
authors.lastname: Monabati
authors.forename: Mahvash Alizadeh
authors.initials: MA
authors.lastname: Naini
authors.forename: Kamran Bagheri
authors.initials: KB
authors.lastname: Lankarani
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Fattahi
authors.forename: Maysam
authors.initials: M
authors.lastname: Asadilari
mesh_terms: 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