Guess what's in the slide? It's exactly what it says. Question is at the first part of the post. Instructions at the second part of the post.
Winner: @scholaris.stem
Honorable Mention: @nikv
Both got 1 HBD from for this exercise.
Answer: Poorly Cohesive Carcinoma
Signet ring cell features are a subvariant of Poorly Cohesive Carcinoma. Signet ring cells look exactly as how they are named which is why I stressed the hint on the high power field view. This case was signed out as Poorly Cohesive Carcinoma. The name came from how the cancer cells lack cohesiveness (don't appear to be sticking together well). There are some features of the poorly cohesive carcinoma that have cells not displaying the signet ring morphology but seeing them on the microscope helps support the diagnosis.
If you check out the architecture of the mucosa on scanner and low power view, you would see that these cancer cells destroy the surrounding lamina propria and leave the glands undisturbed.
Taken at 40x magnification.
Taken at 100x magnification.
Taken at 400x magnification.
Specimen: Stomach
Taken from a 72 year old female who presented who complained of indigestion, early satiety, and loss of appetite.
If you google up the case, there's a high chance you'll get the broader term for the diagnosis on this one. What I'm looking for is the specific term used by WHO classification. This is relatively easier to compared to the previous case but harder compared to Case 1.
Hint: High Power Field (400x) and Scanner (40x) view is the best lead for this case.
Link to the Gross picture of the specimen.
The bounty for this case is 1 HBD.
The bounty for Case 2 is now 2 HBD.
The first one that guesses this right gets that HBD. The prize gradually increases when no one gets it right for each successive post on the series. At the very least, each post has a 1 HBD bounty on it. I'll prioritize adding more bounties on older questions compared to new questions in the series.
The mechanics of the guessing game:
I post the images and give a small detail about it with a corresponding question.
Comment the answer and whoever gets it right first wins the prize. There's a time stamp on the comment section so it's easy to determine the winner if multiple users got it right.
In the event that no one gets it right, the contest will still be open indefinitely. Feel free to ping me if you backread the previous posts in the series.
I'll add new conditions to the game as needed.
You are free to Google for answers or use whatever means you got at your disposal with a corresponding reason why you think it is so. It's easy to get it right by throwing words around so I want to see whether you studied the image.
Make as many attempts as you want. The only time an attempt isn't allowed is when the contest has been closed. There can only be one winner per post. You can try multiple times but spamming some answers from a bucket list isn't going to be get you a reward.
Since you have the advantage of googling the answer. I'd be requiring a short explanation why. It doesn't need to be the exact rationale but if you're close enough I wouldn't mind. This is to prevent anyone that just answers and win through dumb luck, I'd like to see some conviction on the answers.
Note:
I'll be copypasting the mechanics of the game including this line so that anyone who is new to the series wouldn't have to click more links just to backtrack what's going on. If anyone wants to cry I'm milking the reward pool by posting copy paste posts, understand the images here are from actual cases where I took the time to have them recorded.
I highly encourage you to research the answer in the hopes you can actually learn from the experience. Pathology is fun.
I'm also confident you can't find any image that match exactly as the ones I'm sharing because these are from my personal study slides. You can of course see similar images because they can show the same histomorphologic findings you'd expect from the specimen.
Good Luck!
If you made it this far reading, thank you for your time.