A case for the panel: anemone cell tumor

Our plain-English summary of A case for the panel: anemone cell tumor, by R. Sibley, J. Rosai, W. Froehlich (Ultrastructural Pathology, 1980).

The study

• Authors: R. Sibley, J. Rosai, W. Froehlich
• Journal: Ultrastructural Pathology
• Published: 1980;1(3):449-53
• Type of article: Case report
• Cited by: 30 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter presented a puzzling case to an expert panel and published the panel's comments. The patient was a 49-year-old man who had swelling of the lymph nodes in the right and then the left back of the neck, at two times some years before the current admission. The first biopsy was diagnosed as metastatic carcinoma and the second as histiocytic lymphoma. After the second biopsy he received 4000 rads to each cervicosupraclavicular region and responded. Later he developed a 2 x 1-cm mass in the left nasopharynx and a 1.5-cm left posterior neck mass, and both were biopsied. Light microscopy showed round and polygonal tumor cells filling the lymph node sinuses. Electron microscopy showed oval cells with very prominent branching filopodia, 80-200 nm in diameter. Basal lamina, cell junctions, tonofilaments and secretory products other than lipids were absent. Metastatic mesothelioma, nasopharyngeal carcinoma, lymphoma, hairy cell leukemia and malignant histiocytosis were considered but not supported, so the tumor was called an "anemone cell tumor." Four panel responses followed. Two said mesothelioma could not be excluded, although the clinical history was hard to reconcile with it. One suggested a metastatic undifferentiated adenocarcinoma. One had never seen this appearance. One panelist raised the possibility of a previously unrecognized entity. No definite diagnosis was reached.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a letter to the editor describing one patient, followed by comments from a panel of outside pathologists. The authors examined a neck lymph node biopsy from a 49-year-old man. Swollen neck lymph nodes had been biopsied twice in earlier years, with diagnoses first of metastatic carcinoma and then of histiocytic lymphoma. After the second biopsy he received 4000 rads of radiation to each side of the neck and collarbone region. When a neck mass returned, along with a mass in the nasopharynx, electron microscopy of the new lymph node biopsy showed oval cells with very prominent branching surface projections. Basal lamina, cell junctions, tonofilaments and secretory products other than lipids were absent. The authors considered metastatic mesothelioma, nasopharyngeal carcinoma, lymphoma and other diagnoses, but none was supported. They gave the tumor the descriptive name "anemone cell tumor" and asked the panel for its views. Two panelists said mesothelioma could not be excluded, two suggested a possible undifferentiated adenocarcinoma, and one did not know what it was. The article did not mention asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report in the form of a letter to the editor, with comments from a panel of consulting pathologists
• Who was studied: one 49-year-old male patient with a cervical (neck) lymph node tumor, biopsied three times; the authors were at the University of Minnesota and Kaiser Permanente, Oregon
• Main results:
  • Electron microscopy of the third lymph node biopsy showed oval cells with extremely prominent (80-200 nm in diameter) branching filopodia filling the spaces between cells
  • Basal lamina, intercellular junctions, tonofilaments and secretory products (other than lipids) were absent
  • Metastatic mesothelioma, metastatic nasopharyngeal carcinoma, malignant lymphoma, hairy cell leukemia and malignant histiocytosis were considered but were not supported, so the tumor was given the descriptive name anemone cell tumor
  • Panelist Battifora considered mesothelioma still a possibility on morphology, while noting that chest involvement would be expected by now
  • Panelists Kaiserling and Lennert wondered whether the tumor might be a metastasis of an undifferentiated adenocarcinoma
  • Panelist Kim had never encountered this type of cell surface appearance and did not know what the tumor was
  • Panelist Mackay said the microvilli suggested a mesothelioma that could not be excluded, but found this hard to reconcile with the clinical history
• The authors' conclusion: The authors did not reach a diagnosis; they gave a descriptive designation and asked the panelists for their opinion on the origin of this apparently metastatic, but possibly primary nodal, tumor
• Limitations the authors state:
  • Tissue from the first lymph node biopsy was not available for review
  • The nasopharyngeal biopsy was crushed and distorted

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Biopsy, Carcinoma, Mesothelioma, Adenocarcinoma.

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