Difference between revisions of "Signet ring cell carcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Signet ring cell carcinoma - very high mag.jpg
| Width      =
| Caption    = Signet ring cell carcinoma. [[H&E stain]]
| Micro      = ovoid cells with abundant cytoplasm and a peripheral crescentic hyperchromatic nucleus
| Subtypes  =
| LMDDx      = [[serous fat atrophy]], benign histiocytes ([[mucocele]], [[xanthoma]])
| Stains    = [[mucicarmine stain]], [[PAS stain]]
| IHC        = pankeratin +ve, CD68 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[stomach]], [[breast]], many others
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
}}
{{ Infobox external links
{{ Infobox external links
| Name          = {{PAGENAME}}
| Name          = {{PAGENAME}}

Revision as of 00:11, 9 July 2013

Signet ring cell carcinoma
Diagnosis in short

Signet ring cell carcinoma. H&E stain
LM ovoid cells with abundant cytoplasm and a peripheral crescentic hyperchromatic nucleus
LM DDx serous fat atrophy, benign histiocytes (mucocele, xanthoma)
Stains mucicarmine stain, PAS stain
IHC pankeratin +ve, CD68 -ve
Site stomach, breast, many others
Signet ring cell carcinoma
External resources
EHVSC Eastern Health Virtual Slide Collection (EHVSC) [http://eh-aperio/EditRecord.php?TableName=Slide&Ids%5B%5D=9982 9982 Eastern Health Virtual Slide Collection (EHVSC) 9982]
Wikipedia Signet ring cell carcinoma

Signet ring cell carcinoma, abbreviated SRCC, is a type of malignant epithelial neoplasm that can arise from a number of places. It is commonly associated with the stomach.

General

  • It has been said that there are two types of pathologists... those that have missed SRCCs and those that will miss SRCCs.

Differential diagnosis

It may arise from the:[1]

Microscopic

Features:

  • Signet ring cells resemble signet rings.
    • They contain a large amount of mucin, which pushes the nucleus to the cell periphery.
    • The pool of mucin in a signet ring cell mimics the appearance of the finger hole.
    • The nucleus mimics the appearance of the face of the ring in profile.
  • Signet ring cells are typically 2-3x the size of a lymphocyte.
    • Smaller than the typical adipocyte.
  • Often have a crescent-shaped or ovoid nucleus.
    • Capillaries sectioned on their lumen have endothelial cells - the nuclei of these are more spindled.

Note:

  • SRCs are usually close to friend, i.e. they are adjacent to another SRC.
    • This helps differentiate SRCs from capillaries sectioned on their lumen.
  • The mucin is often clear on H&E... but maybe eosinophilic.

DDx:

  • Serous fat atrophy.[2]
  • Mucocele - muciphages may mimic signet ring cells.[3]
    • Muciphages = cytoplasm lightly eosinophilic, multivaculated (classic) or finely reticulated.

Images

www:

  • SRCC - low mag. - demonstrating that it can be subtle. (WC/Nephron)

  • SRCC - high mag. (WC/Nephron)

  • SRCC - very high mag. (WC/Nephron)

  • SRCC metastasis. (WC/Nephron)

  • SRCC. (WC/KGH)

  • SRCC - PAS stain. (WC/KGH)

Stains

  • PAS stain +ve.
  • Alican blue-PAS stain +ve.

IHC

  • AE1/AE3 +ve.
  • CK7 +ve.

See also

References

  1. ↑ URL: http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/what-is-a-signet-cell-cancer. Accessed on: 7 March 2012.
  2. ↑ Clarke, BE.; Brown, DJ.; Xipell, JM. (Jan 1983). "Gelatinous transformation of the bone marrow.". Pathology 15 (1): 85-8. PMID 6222282.
  3. ↑ De Petris, G.; Lev, R.; Siew, S. (May 1998). "Peritumoral and nodal muciphages.". Am J Surg Pathol 22 (5): 545-9. PMID 9591723.
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