Medicine:Signet ring cell

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Short description: Cell with a large vacuole
Signet ring cell, as seen in a case of colon adenocarcinoma with mucinous features, showing a tumor cell with a vacuole of mucin. H&E stain.
Signet ring for comparison.

In histology, a signet ring cell is a cell with a large vacuole. The malignant type is seen predominantly in carcinomas. Signet ring cells are most frequently associated with stomach cancer,[1] but can arise from any number of tissues including the prostate,[2] bladder, gallbladder,[3] breast, colon,[4] ovarian stroma and testis.[5]

Types

The NCI Thesaurus identifies the following types of signet ring cell

  • Castration cell, a non-malignant cell arising in the anterior pituitary gland under certain abnormal hormonal conditions.
  • Neoplastic thyroid gland follicular signet ring cell
  • Signet ring adenocarcinoma cell
  • Signet ring melanoma cell
  • Signet ring stromal cell

Appearance

The name of the cell comes from its appearance; 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 a finger hole and the nucleus mimics the appearance of the face of the ring in profile.

  • Gastric signet ring cell carcinoma. H&E stain.

  • A signet ring-like foamy macrophage, which may mimic a cancer cell, but the texture of the nucleus is similar to that of a normal macrophage.

  • High magnification micrograph showing signet ring cells, with clear cytoplasm, in metastatic breast carcinoma. H&E stain.

  • Signet ring cells (magenta) stained with PAS in a gastric signet ring cell carcinoma.

Diagnostic significance

A significant number of signet ring cells, generally, are associated with a worse prognosis.[6][7]

Classification of carcinomas

SRC carcinomas can be classified using immunohistochemistry.[8]

See also

  • Signet ring cell carcinoma

References

  1. ↑ Cancer Research UK. Signet Ring Cancer. cancerhelp.org.uk. URL: http://www.cancerhelp.org.uk/help/default.asp?page=7581 . Accessed on: November 2, 2007.
  2. ↑ "Signet-ring carcinoma of the prostate". Pathol. Res. Pract. 192 (12): 1232–8; discussion 1239–41. 1996. doi:10.1016/S0344-0338(96)80156-7. PMID 9182294. 
  3. ↑ "A case of ovarian metastasis of gallbladder carcinoma simulating primary ovarian neoplasm: diagnostic pitfalls and review of literature". Int. J. Gynecol. Cancer 16 Suppl 1: 319–21. 2006. doi:10.1111/j.1525-1438.2006.00335.x. PMID 16515613. 
  4. ↑ "Primary signet-ring cell carcinoma of the colon and rectum: report of eight cases and review of 154 Japanese cases". Hepatogastroenterology 53 (72): 845–9. 2006. PMID 17153438. 
  5. ↑ "Primary signet-ring stromal tumor of the testis". Virchows Arch. 447 (1): 107–10. 2005. doi:10.1007/s00428-005-1218-2. PMID 15909171. 
  6. ↑ "Treatment outcomes in patients with signet ring cell carcinoma of the colorectum". Am. J. Surg. 194 (3): 294–8. 2007. doi:10.1016/j.amjsurg.2006.12.041. PMID 17693269. 
  7. ↑ Cabebe EC, Mehta VK, Fisher G. Gastric Cancer. eMedicine.com. URL: http://www.emedicine.com/med/topic845.htm. Accessed on: November 8, 2007.
  8. ↑ "Phenotypic classification of gastric signet ring cell carcinoma and its relationship with clinicopathologic parameters and prognosis". World J. Gastroenterol. 13 (23): 3189–98. 2007. PMID 17589897. 

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