Clinicopathological characteristics of signet‐ring cell carcinoma derived from gastric fovelar epithelium

Abstract

We aimed to investigate the immunophenotype, differential diagnosis, and clinicopathological characteristics of signet-ring cell carcinoma (SRCC) derived from gastric foveolar epithelium.Methods: Clinical characteristics, endoscopic findings, histopathological features, and follow-up data of seven cases of SRCC derived from gastric foveolar epithelium with small intramucosal lesions were analyzed.Results: Seven patients with a mean age of 38.3 years were diagnosed with SRCC derived from gastric foveolar epithelium and small intramucosal lesions, all of them were negative for CDH-1 germline mutation. The glands proliferated and expanded, and then morphologically transformed into signet-ring cells and formed clonal hyperplastic SRCC, which expanded laterally along the gastric foveolar cells to a length of 3-6 mm. Periodic acid Schiff staining was positive, while CK7 and MUC6 were negative, in all cases. Ki-67-positive cells ranged 37%-60%. During a follow-up period of 6-30 months, no patients experienced tumor recurrence or metastasis.Conclusions: SRCC derived from gastric foveolar epithelium is originated from the proliferative region of the bottom of the gastric pit and gland neck. It is easily missed diagnosed or misdiagnosed as it grows laterally along the gastric foveolar cells. Biological behavior, genetics, and etiology of such SRCC, as well as the clinicopathological characteristics, need to be further studied.

The occurrence, progression and development of four types of gastric mucosal atrophic lesions and their histopathological characteristics

“…Atrophy can occur in the intestinal type of gastric cancer as well as in the gastric type. The previous study conducted by the authors of the present study reported that Helicobacter pylori infection leads to gastric small concave epithelial type signet-ring cell carcinoma [ 18 ]. In severe atrophy of the lamina propria glands, there is no cellular heterotypic hyperplasia or intestinal metaplasia, including complete intestinal metaplasia and incomplete intestinal metaplasia.…”

“…Four types of gastric mucosal atrophic lesions were proposed according to their pathological stages and characteristics as follows: (1) stage I gastric mucosa gland atrophy: mild atrophy and a smaller volume of the gastric mucosa glands; (2) stage II compensatory proliferative atrophy: polar compensatory hyperplasia and reduced gastric mucosa glands; (3) stage III intestinal metaplastic atrophy (intestinal metaplasia is a transformation of the cells in the lining of the upper digestive tract, often the stomach): a dominant intestinal metaplasia type and the intestinal metaplasia cells accounted for > 30% of the entire gland; and (4) stage IV smooth muscle proliferative atrophy: proliferative atrophy of smooth muscle fragments and smooth muscle fibres of different sizes and shapes appeared in the lamina propria. These four types of classifications are based on a previous study [ 18 ]. Mastering the histological characteristics and pathological stages of atrophic conditions is beneficial to clinicians for the precise treatment of atrophic lesions of the gastric mucosa and the tracking of malignant cell transformation, which is important for reducing the occurrence and development of gastric cancer.…”

A novel web-based dynamic prognostic nomogram for gastric signet ring cell carcinoma: a multicenter population-based study

“…This study focused on the GSRCC nomogram because of its controversial prognosis. Compared to other types of GC, GSRCC has unique tumorigenic properties and atypical epidemiological distribution ( 9 ). Zu et al.…”

Prostate Adenocarcinoma with Signet-Ring Cells and Features of Mucin: A Clinical Case and Literature Review

“…Despite constantly changing terminology, the lack of strict diagnostic criteria, and unestablished investigative protocols, which all together pose additional issues calculating the incidence of the disease, it is clear that a true prostatic SRCC is extremely rare, with an estimated prevalence of 0.02% among all prostate adenocarcinoma cases [ 5 ]. Due to its rare nature, the close epidemiological relation to the gastrointestinal tract, and diffuse, lateral, submucosal growth pattern, a diligent diagnostic workup for differentials must be carried out since the location of the primary tumor may be an independent factor for the cause-related survival and virulence of the disease [ 7 , 13 ]. The investigations should include upper gastric endoscopy, colonoscopy, cystoscopy, and abdominal computed tomography to exclude metastatic involvement of the prostate [ 10 ].…”

“…The variant is predominantly observed in the gastrointestinal tract, emphasizing the stomach and colon; therefore, these organs are the first ones to be ruled out in suspicion of metastatic disease and are a reference point in other-organ signet-ring cell carcinoma (SRCC) cases [ 5 ]. However, it is not an uncomplicated process since early gastric SRCC is nearly macroscopically invisible, meaning that in most cases, it is diagnosed rather late, posing a great diagnostic and therapeutic challenge [ 7 ].…”