Peritumoral and nodal muciphages

G De Petris1, R Lev, S Siew

  • 1Department of Pathology, Roger Williams Hospital, Brown University School of Medicine, Providence, Rhode Island 02908, USA.

Insights

Researchers identified muciphages, cells containing epithelial mucin, in lymph nodes of cancer patients. This novel finding in lymph nodes requires careful differentiation from adenocarcinoma to ensure accurate diagnosis.

Area of Science:

  • Pathology
  • Oncology
  • Cell Biology

Background:

  • Muciphages are typically found in soft tissues, characterized by their vacuolated cytoplasm containing mucin.
  • Their presence in lymph nodes, particularly in cancer patients, has not been previously documented.

Purpose of the Study:

  • To report the novel identification and characterization of muciphages within the lymph nodes of cancer patients.
  • To differentiate these muciphages from metastatic adenocarcinoma based on morphological and immunohistochemical features.

Main Methods:

  • Histopathological examination of lymph node and surrounding soft tissue biopsies from three cancer patients.
  • Application of mucin stains (Alcian blue, periodic acid-Schiff with diastase digestion) and enzyme digestion (hyaluronidase).
  • Immunohistochemical analysis using markers for macrophages (KP-1, Mac-387) and exclusion markers (cytokeratin, S-100, leukocyte common antigen - LCA).

Main Results:

  • Alcian blue positive cells with vacuolated cytoplasm, some indenting nuclei (signet-ringlike appearance), were observed in lymph node sinusoids and soft tissues.
  • Immunohistochemistry confirmed these cells were positive for KP-1 and Mac-387, and negative for cytokeratin, S-100, and LCA, supporting macrophage lineage.
  • Intracellular material was strongly periodic acid-Schiff positive post-diastase and Alcian blue positive, indicating epithelial-type mucin.

Conclusions:

  • This study presents the first report of muciphages in regional lymph nodes of cancer patients.
  • The findings highlight the importance of distinguishing muciphages from metastatic signet-ring or mucinous adenocarcinoma through careful morphological and immunohistochemical evaluation.
  • Accurate identification of muciphages is crucial for correct cancer staging and patient management.

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