Ultrastructural Pathology
ISSN: 0191-3123 (Print) 1521-0758 (Online) Journal homepage: http://www.tandfonline.com/loi/iusp20
Anemone Cell Tumor Revisited Per H. B. Carstens To cite this article: Per H. B. Carstens (1992) Anemone Cell Tumor Revisited, Ultrastructural Pathology, 16:4, iii-v, DOI: 10.3109/01913129209057824 To link to this article: http://dx.doi.org/10.3109/01913129209057824
Published online: 10 Jul 2009.
Submit your article to this journal
Article views: 1
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iusp20 Download by: [185.34.33.2]
Date: 15 March 2016, At: 10:57
Editorial
Downloaded by [185.34.33.2] at 10:57 15 March 2016
Anemone Cell Tumor Revisited
In 1980, Sibley, Rosai, and Froehlich described an apparent metastatic neoplasm in a cervical lymph node of 1 1 l/2 years duration.’ This tumor was ultrastructurally characterized by extremely prominent filopodia and lacked basal laminae, intracellular junctions, tonofilaments, and secretory products. Since the tumor did not fit well into any o f the considered differential diagnoses, such as metastatic mesothelioma, nasopharyngeal carcinoma, malignant lymphoma, hairy cell leukemia, or malignant histiocytosis, a descriptive term anemone cell tumor (ACT) was coined. Five years later, the same authors reexamined the original case immunohistochemically with a battery of antisera. Only vimentin was positive.2 Since the original description, several tumors with anemone cell features have been published and classified as squamous cell carcinoma^,^,^^^ l y m p h ~ m a , ~ ~ ~ ~ ’ ~ 14 pancreatic c a r ~ i n o m a ,transitional ~ cell carcinoma, gastric carcinoid,15 Merkel cell carcinoma,16 and e ~ e n d y m 0 m a . lUnfortunately, ~ many of the authors of these articles have not adhered t o the original description of this ultrastructurally distinctive neoplasm or have added n e w features. In either instance the tumor described is n o t a true ACT. In the first category, several reports of “filiform” large cell lymphomas claimed t o be ACTs were f ~ u n d . ~ .’,13 ’ , ~The anemone pattern should be dominant throughout the tumor, n o t just a pattern seen in some areas.’ For example, it is not unusual for some mesotheliomas or poorly differentiated adenocarcinomas to have areas of anemone growth. Furthermore, the microvillilike cell extensions 6-8.11,13 and should should be found all over the cell surface, not just in focal areas be microvillilike, not thick and short w i t h broad-based openings from the main cell body.6r9 In the second category, ultrastructural features not included in the original 14.1 6,17 lysoreport, are desmosomes and to no filament^,^^^ intermediate filaments, 14 somes, basal lamina rnaterial,l5,l7 electron-dense and intracytoplasmic 1urnina.l’ By adhering strictly t o the ultrastructural findings of the original case, it appears that most published cases are not true ACTs. Of the 45 additional cases in 7,10,12,19,20 Of these, the l i t e r a t ~ r e , ~ .only ~ ’ nine emerge as potentially true ACTs. four are “anecdotal”: ie, they have only been briefly mentioned by panelist^.'^,^^ Furthermore, the t w o cases mentioned by Sibley and Rosai” contained “small dense granules,” a feature not present in their original report.’ The t w o cases mentioned by Battifora2* did not possess desmosomes or tonofilaments, but stained positively for AE1, thereby supporting a squamous cell origin. The remaining five fully reported true ACTs are further classified as follows: 7.10.12 four are large cell lymphomas and one is most likely a pancreatic carcitwo out of their five cases of ACTs as n ~ m a Taxy . ~ and A l m a n a ~ e e rdescribe ~ being lymphomas because of the presence of leukocyte surface antigen T29/33 in one case and intracytoplasmic immunoglobulin in the other case. Huntrakoon and Bhatia” reported one case that was tested by Battifora” for leukocyte comCopyright
0
Ultrastructural Pathology, 16:iii-v, 1992 1992 by Hemisphere Publishing Corporation
...
111
IV
Editorial
Downloaded by [185.34.33.2] at 10:57 15 March 2016
mon antigen (LCA) and keratin antigens; the former reacted positively, the latter negatively. Erlandson and Filippa" described one case that reacted positively for LCA and epithelial membrane antigen. Taxy and Almanaseer' also reported the only example in the literature of an ACT of possible carcinomatous origin. Immunostains for keratin and carcinoembryonic antigen were negative, but an autopsy, one year after diagnosis, showed a 12 c m carcinoma in the head of the pancreas with similar histology t o the biopsy. ACT can therefore represent a form of anaplastic large cell lymphoma and possibly, but not yet conclusively proven, carcinoma. It therefore appears that not much has changed regarding the origin of ACT since the 1985 editorial." In order t o prove that ACT can be of other origin than lymphomatous, all new cases of true ACT should be examined by a broad panel of immunohistochemical antibodies. Per H. 6. Carstens Department of Pathology Medical Dental Research Bldg. 208 University of Louisville Louisville, Kentucky 40292, USA
REFERENCES 1. Sibley R, Rosai J, Froehlich W. A case for the panel: anemone cell tumor. Ultrastruct Pathol. 1980; 1: 449-453. 2. Sibley R, Rosai J, Froehlich W. Comments by the panel. Ultrastruct Pafhol. 1985;8:369-371. 3. Schwarz R, Marquet E. Readers' forum. Another look at the "anemone cell." Ultrastruct Pathol. 1982;3:209-212. 4. Sidhu GS. Readers' forum. Another look at the "anemone cell." Ultrastruct Pathol. 1982;3:21 1-213. 5. Phillips JI, Murray J, Verhaart S. Squamous cell carcinoma with anemone cell features. Ultrastruct Pathol. 1987; 1 1:47-52. 6. Osborne BM, Mackay B, Butler JJ, Ordonez NG. Large cell lymphoma w i t h microvillus-like projections: an ultrastructural study. Am J Clin Pathol. 1983;79:443-450. 7. Taxy JB, Almanaseer IY. "Anemone" cell (villiform) tumors: electron microscopy and immunohistochemistry of five cases. Ultrastruct Pathol. 1984;7: 143- 150. 8. Widgren S. Malignant immunoblastic lymphoma with filopodia (so-called anemone or porcupine cell turnour). Path Res Pract. 1985;180:563-566, 9. Font RL, Shields J. Large cell lymphoma of the orbit w i t h microvillus projections ("Porcupine lymphoma"). Arch Ophthalmol. 1985; 103: 1 7 1 5- 17 19. 10. Huntrakoon M, Bhatia P. Case for the panel. Anemone cell tumor. Ultrastruct Pathol. 1985;8:369373. 1 1. Bernier V, Azar HA. Filiform large-cell lymphomas. An ultrastructural and immunohistochemical study. Am J Surg Pathol. 1987; 1 1:387-396. 12. Erlandson RA, Filippa DA. Unusual non-Hodgkin's lymphomas and true histiocytic lymphomas. Uitrastruct Pathol. 1989; 13:249-273. 13. lshihara T, Takahashi M, Uchino F. Intriguing case. A filiform large cell lymphoma in the spleen: a case report w i t h immunohistochemical and electron microscopic study. Ultrastruct Pathol. 1990; 14: 193199. 14. Wirt DP, Nagle RB, Gustafson HM, Philpott RJ, Kuivinen NA, Schuchardt M. The probable origin of an anemone cell tumor: metastatic transitional cell carcinoma producing HCG. Ultrastruct Pathol. 1984; 71277-288. 15. Lombardi L, Andreola S . Quarterly case. Gastric carcinoid with unusual ultrastructural features. Ultrastruct Pathol. 1988; 12:247-250. 16. Wills EJ. Anemone cell tumor w i t h neuroendocrine differentiation (presumed Merkel cell carcinoma). Ultrastruct Pathoi. 1990; 14: 16 1- 1 7 1 . 17. Deck JHN, Ramjohn S, Dardick I. Intriguing case. "Anemone" cell (villiform) tumor of the brain. Ultrastruct Pathol. 1990; 14:07-94.
Editorial
V
Downloaded by [185.34.33.2] at 10:57 15 March 2016
18. Erlandson RA. Axillary sweat gland carcinoma versus amelanotic malignant melanoma. Ultrastrucf Pafhol. 1985;9:51-57. 19. Sibley R , Rosai J. Readers' forum. Another look at the "anemone cell." Reply from the authors. Ulfrastruct Parhol. 1982; 3: 2 12-2 14. 20. Battifora H. Case for the panel. Anemone cell tumor. Comments by the panel. Ultrasrruct Pathol. 1985;8:371-373. 21. Sobrinho-Sirnoes M, Nesland JM, Johannessen JV. The mystery of the anemone cell tumor. Editorial. Ulfrastruct Parhol. 1985;8(4):iii-iv.
ISSN: 0191-3123 (Print) 1521-0758 (Online) Journal homepage: http://www.tandfonline.com/loi/iusp20
Anemone Cell Tumor Revisited Per H. B. Carstens To cite this article: Per H. B. Carstens (1992) Anemone Cell Tumor Revisited, Ultrastructural Pathology, 16:4, iii-v, DOI: 10.3109/01913129209057824 To link to this article: http://dx.doi.org/10.3109/01913129209057824
Published online: 10 Jul 2009.
Submit your article to this journal
Article views: 1
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iusp20 Download by: [185.34.33.2]
Date: 15 March 2016, At: 10:57
Editorial
Downloaded by [185.34.33.2] at 10:57 15 March 2016
Anemone Cell Tumor Revisited
In 1980, Sibley, Rosai, and Froehlich described an apparent metastatic neoplasm in a cervical lymph node of 1 1 l/2 years duration.’ This tumor was ultrastructurally characterized by extremely prominent filopodia and lacked basal laminae, intracellular junctions, tonofilaments, and secretory products. Since the tumor did not fit well into any o f the considered differential diagnoses, such as metastatic mesothelioma, nasopharyngeal carcinoma, malignant lymphoma, hairy cell leukemia, or malignant histiocytosis, a descriptive term anemone cell tumor (ACT) was coined. Five years later, the same authors reexamined the original case immunohistochemically with a battery of antisera. Only vimentin was positive.2 Since the original description, several tumors with anemone cell features have been published and classified as squamous cell carcinoma^,^,^^^ l y m p h ~ m a , ~ ~ ~ ~ ’ ~ 14 pancreatic c a r ~ i n o m a ,transitional ~ cell carcinoma, gastric carcinoid,15 Merkel cell carcinoma,16 and e ~ e n d y m 0 m a . lUnfortunately, ~ many of the authors of these articles have not adhered t o the original description of this ultrastructurally distinctive neoplasm or have added n e w features. In either instance the tumor described is n o t a true ACT. In the first category, several reports of “filiform” large cell lymphomas claimed t o be ACTs were f ~ u n d . ~ .’,13 ’ , ~The anemone pattern should be dominant throughout the tumor, n o t just a pattern seen in some areas.’ For example, it is not unusual for some mesotheliomas or poorly differentiated adenocarcinomas to have areas of anemone growth. Furthermore, the microvillilike cell extensions 6-8.11,13 and should should be found all over the cell surface, not just in focal areas be microvillilike, not thick and short w i t h broad-based openings from the main cell body.6r9 In the second category, ultrastructural features not included in the original 14.1 6,17 lysoreport, are desmosomes and to no filament^,^^^ intermediate filaments, 14 somes, basal lamina rnaterial,l5,l7 electron-dense and intracytoplasmic 1urnina.l’ By adhering strictly t o the ultrastructural findings of the original case, it appears that most published cases are not true ACTs. Of the 45 additional cases in 7,10,12,19,20 Of these, the l i t e r a t ~ r e , ~ .only ~ ’ nine emerge as potentially true ACTs. four are “anecdotal”: ie, they have only been briefly mentioned by panelist^.'^,^^ Furthermore, the t w o cases mentioned by Sibley and Rosai” contained “small dense granules,” a feature not present in their original report.’ The t w o cases mentioned by Battifora2* did not possess desmosomes or tonofilaments, but stained positively for AE1, thereby supporting a squamous cell origin. The remaining five fully reported true ACTs are further classified as follows: 7.10.12 four are large cell lymphomas and one is most likely a pancreatic carcitwo out of their five cases of ACTs as n ~ m a Taxy . ~ and A l m a n a ~ e e rdescribe ~ being lymphomas because of the presence of leukocyte surface antigen T29/33 in one case and intracytoplasmic immunoglobulin in the other case. Huntrakoon and Bhatia” reported one case that was tested by Battifora” for leukocyte comCopyright
0
Ultrastructural Pathology, 16:iii-v, 1992 1992 by Hemisphere Publishing Corporation
...
111
IV
Editorial
Downloaded by [185.34.33.2] at 10:57 15 March 2016
mon antigen (LCA) and keratin antigens; the former reacted positively, the latter negatively. Erlandson and Filippa" described one case that reacted positively for LCA and epithelial membrane antigen. Taxy and Almanaseer' also reported the only example in the literature of an ACT of possible carcinomatous origin. Immunostains for keratin and carcinoembryonic antigen were negative, but an autopsy, one year after diagnosis, showed a 12 c m carcinoma in the head of the pancreas with similar histology t o the biopsy. ACT can therefore represent a form of anaplastic large cell lymphoma and possibly, but not yet conclusively proven, carcinoma. It therefore appears that not much has changed regarding the origin of ACT since the 1985 editorial." In order t o prove that ACT can be of other origin than lymphomatous, all new cases of true ACT should be examined by a broad panel of immunohistochemical antibodies. Per H. 6. Carstens Department of Pathology Medical Dental Research Bldg. 208 University of Louisville Louisville, Kentucky 40292, USA
REFERENCES 1. Sibley R, Rosai J, Froehlich W. A case for the panel: anemone cell tumor. Ultrastruct Pathol. 1980; 1: 449-453. 2. Sibley R, Rosai J, Froehlich W. Comments by the panel. Ultrastruct Pafhol. 1985;8:369-371. 3. Schwarz R, Marquet E. Readers' forum. Another look at the "anemone cell." Ultrastruct Pathol. 1982;3:209-212. 4. Sidhu GS. Readers' forum. Another look at the "anemone cell." Ultrastruct Pathol. 1982;3:21 1-213. 5. Phillips JI, Murray J, Verhaart S. Squamous cell carcinoma with anemone cell features. Ultrastruct Pathol. 1987; 1 1:47-52. 6. Osborne BM, Mackay B, Butler JJ, Ordonez NG. Large cell lymphoma w i t h microvillus-like projections: an ultrastructural study. Am J Clin Pathol. 1983;79:443-450. 7. Taxy JB, Almanaseer IY. "Anemone" cell (villiform) tumors: electron microscopy and immunohistochemistry of five cases. Ultrastruct Pathol. 1984;7: 143- 150. 8. Widgren S. Malignant immunoblastic lymphoma with filopodia (so-called anemone or porcupine cell turnour). Path Res Pract. 1985;180:563-566, 9. Font RL, Shields J. Large cell lymphoma of the orbit w i t h microvillus projections ("Porcupine lymphoma"). Arch Ophthalmol. 1985; 103: 1 7 1 5- 17 19. 10. Huntrakoon M, Bhatia P. Case for the panel. Anemone cell tumor. Ultrastruct Pathol. 1985;8:369373. 1 1. Bernier V, Azar HA. Filiform large-cell lymphomas. An ultrastructural and immunohistochemical study. Am J Surg Pathol. 1987; 1 1:387-396. 12. Erlandson RA, Filippa DA. Unusual non-Hodgkin's lymphomas and true histiocytic lymphomas. Uitrastruct Pathol. 1989; 13:249-273. 13. lshihara T, Takahashi M, Uchino F. Intriguing case. A filiform large cell lymphoma in the spleen: a case report w i t h immunohistochemical and electron microscopic study. Ultrastruct Pathol. 1990; 14: 193199. 14. Wirt DP, Nagle RB, Gustafson HM, Philpott RJ, Kuivinen NA, Schuchardt M. The probable origin of an anemone cell tumor: metastatic transitional cell carcinoma producing HCG. Ultrastruct Pathol. 1984; 71277-288. 15. Lombardi L, Andreola S . Quarterly case. Gastric carcinoid with unusual ultrastructural features. Ultrastruct Pathol. 1988; 12:247-250. 16. Wills EJ. Anemone cell tumor w i t h neuroendocrine differentiation (presumed Merkel cell carcinoma). Ultrastruct Pathoi. 1990; 14: 16 1- 1 7 1 . 17. Deck JHN, Ramjohn S, Dardick I. Intriguing case. "Anemone" cell (villiform) tumor of the brain. Ultrastruct Pathol. 1990; 14:07-94.
Editorial
V
Downloaded by [185.34.33.2] at 10:57 15 March 2016
18. Erlandson RA. Axillary sweat gland carcinoma versus amelanotic malignant melanoma. Ultrastrucf Pafhol. 1985;9:51-57. 19. Sibley R , Rosai J. Readers' forum. Another look at the "anemone cell." Reply from the authors. Ulfrastruct Parhol. 1982; 3: 2 12-2 14. 20. Battifora H. Case for the panel. Anemone cell tumor. Comments by the panel. Ultrasrruct Pathol. 1985;8:371-373. 21. Sobrinho-Sirnoes M, Nesland JM, Johannessen JV. The mystery of the anemone cell tumor. Editorial. Ulfrastruct Parhol. 1985;8(4):iii-iv.
