Thanks for telling me-- try this one- it should work-- pathpresenter.net/public/presentation/display?token=60c26c60

@@LewisHassell-OPEN 👍

Yes, I am working on collecting the cases for this topic. Thanks for the suggestion

So nice of you

Signet ring cells occur in cancers at several sites, including the esophagus. Generally these tumors are not a favorable diagnosis, but there are several variables, the most important of which are the stage (depth of invasion, any nodal spread, distant metastasis, etc.) and the precise molecular profile. There are several different groups of molecular changes that can be seen with this morphologic subtype of tumor. In our institution, tumors that are still T1a will be treated with endoscopic resection, but any tumor that is stage T1b to T3 will get some type of adjuvant treatment (drugs plus radiation) followed by consideration of a resection procedure. Tumors that are T4 may get targeted treatment depending on whether they express Her2, or standard chemotherapy. I hope that is helpful, and wish you a favorable outcome with this challenging disease.

MICROSCOPIC APPEARANCE: Sections revealed fragments of squamous and columnar lined mucosa. One of the fragment in the stroma beneath shows discrete atypical cells some are of signet ring cell type having vacuolated cytoplasm vesicular nuclei and mild to moderate nuclear atypia. Associated inflammatory cell infiltrates present. Remaining fragments shows normal mucosal lining with inflammatory changes. No extracellular mucin present. No intestinal metaplasia is seen.

Interesting question-- stress does impact many body systems, including the immune system, which plays a role in tumor detection and suppression. So probably yes-- but the timing of the stress, the type, etc. and the eventual appearance of a tumor may be quite difficult to connect since the time from earliest appearance of an abnormal cell to the appearance of a clinically detectable tumor is often many years.

It depends a lot on what "flavor" of lymphoma he has. Some are rapidly growing, aggressive and hard to treat. Others are slower, indolent (and also hard to treat.)

@@LewisHassell-OPEN he says it’s terminal, in that there is no cure, but it’s non aggressive. His white blood cells were 11.8 and there was cloning going on. That’s what triggered the testing. The doctor told him to try to stay calm and not get upset because stress could increase WBC. They aren’t doing chemotherapy because you can’t do it on bone, he said. They didn’t see much in the cat scan. I’m just going to appreciate the time I have left with him and hope for the best. He’s very active for a 70 year old.

Welcome!

Borderline tumors do not respond to conventional chemotherapy, so the side-effects outweigh any potential benefit. I'm not sure about hormonal therapy; it isn't used commonly in our institution, but might have value. check with your gynecologic-oncologist

Sorry to learn of your distress. I am not the right person to ask about symptoms that flare up, but I would imagine you must have a gastrointestinal doctor who could help you manage those.

A better analogy would be of a reservoir nearly to the brim. It isn't going to cause a flood unless some next step occurs- a break in the dam, or a downpour that pushes it over the top. A cancer precursor is like that, a state that awaits some further genetic change before it can progress to become life threatening. That change may come sooner, later, or perhaps not at all.

@@LewisHassell-OPEN so why wouldn't the EMT want to cut or freeze or Lazer it out they just want to wait till it becomes cancer shouldn't they want to get it early before the change?

This is a benign condition that doesn't require any surgery. The importance is for pathologists to recognize it and NOT call it something more serious leading to unnecessary surgery.

@@LewisHassell-OPEN Thank you, Doctor

Again, this is a function of the stage of the disease, the nature of the tumor (HPV-related or not), and the age and overall health of the patient.