Cytologic Features of Primary Signet Ring Cell Carcinoma of the Bladder

Kim, Sung Sun; Choi, Yoo Duk; Nam, Jong Hee; Kwon, Dong Deuk; Juhng, Sang Woo; Choi, Chan

doi:10.1159/000325314

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…Microscopically, signet-ring cells are described as crescent-shaped cells containing nuclei compressed to one edge of the cell by large amounts of cytoplasmic mucin appearing as a single clear vacuole in some tumors and as a foamy, multivesicular, cytoplasmic material in others [4,8] . Mucin accumulations form in the cytoplasm and nuclei are unevenly distributed [7,9,10] . The extent of the signet-ring component is associated with advanced stage and worse survival; however, the exact percentage of signet-ring cells that must be present in order to make the diagnosis of SRBC has not been established.…”

Section: Introductionmentioning

confidence: 99%

“…Most of these reports were retrospective reviews from single institutional experiences and focused on the histopathology [9][10][11] , with fewer reports concerning treatment outcomes and follow-up. With the demographic characteristics and clinical outcomes of SRCC still ill-defined, our study aims to examine these in patients identified through the Surveillance, Epidemiology, and End Results (SEER) program database and to determine the prognostic factors impacting cancer-specific survival.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Outcomes of Patients with Primary Signet-Ring Cell Carcinoma of the Urinary Bladder

Wang

2011

Urol Int

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Objective: The aim of this study was to examine the epidemiology, natural history, treatment pattern and predictors of long-term survival of patients with signet-ring cell carcinoma (SRCC) of the urinary bladder based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. Methods and Results: In total, 230 patients with pathologically confirmed SRCC of the urinary bladder were identified between 1973 and 2004. The mean age was 65 ± 13 years. Overall, 75.7% of the patients had a poorly differentiated or undifferentiated histology grade, 26.5% presented with metastatic disease, 59 (25.7%) underwent transurethral resection for bladder tumor only and 107 (46.5%) had partial or radical cystectomy. The 1-, 3- and 10-year cancer-specific survival rates were 66.8, 40.6 and 25.8%, respectively. Using multivariable Cox proportional hazard model, age (HR 1.024; p = 0.004), stage (distant vs. local, HR 6.2; p < 0.001) and cystectomy (HR 0.53; p = 0.002) were identified as independent predictors for cancer-specific survival. Conclusions: Receipt of cystectomy was strongly associated with improved survival in the patients with SRCC of urinary bladder. However, many patients with localized tumors did not receive potentially curative cystectomy. Further studies to address the barriers to the delivery of appropriate care to these patients are warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Patients with Primary Signet-Ring Cell Carcinoma of the Urinary Bladder

Wang

2011

Urol Int

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Section: Discussionmentioning

confidence: 99%

“…Signet ring cell adenocarcinoma has a dismal prognosis, with 5-year survival, a mere 23% [ 1 , 4 , 13 ]. This diagnosis requires that signet ring cells comprise the tumor exclusively, as these cells may also be components of mixed adenocarcinomas or UC [ 9 , 11 , 13 ]. Grossly, these tumors are infiltrative, with subepithelial growth that results in bladder wall thickening; often, no discrete mass is visible on cystoscopy [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Urinary Bladder Adenocarcinoma Metastatic to the Abdominal Wall: Report of a Case with Cytohistologic Correlation

Nath

Baliga

2016

Case Reports in Pathology

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We report a case of adenocarcinoma metastatic to the abdominal wall in a 71-year-old man with a history of primary bladder adenocarcinoma. CT-guided core biopsy was performed; imprints and histologic sections showed malignant glands lined by tumor cells with hyperchromatic nuclei and prominent nucleoli, infiltrating through skeletal muscle. Immunohistochemistry revealed positivity for CK7, membranous/cytoplasmic β-catenin, caudal-type homeobox transcription factor 2 (CDX2), and α-methylacyl coenzyme A racemase and negativity for CK20, p63, prostate-specific antigen (PSA), and prostate-specific acid phosphatase (PSAP). These findings were interpreted as metastatic adenocarcinoma, consistent with bladder primary. Primary bladder adenocarcinoma is a rare malignancy arising within glandular metaplasia and is associated with cystitis cystica and cystitis glandularis. Predisposing factors include bladder exstrophy, schistosomiasis, and other causes of chronic bladder irritation. This tumor is divided into intestinal, clear cell, and signet ring cell subtypes. Treatment involves radical cystectomy with pelvic lymph node dissection, and prognosis is unfavorable. Primary bladder adenocarcinoma should be differentiated from urachal adenocarcinoma, which arises from urachal remnants near the bladder dome, and secondary adenocarcinoma, or vesical involvement by adenocarcinoma from a different primary. CK7, CK20, CDX2, thrombomodulin, and β-catenin can help distinguish primary bladder adenocarcinoma from colonic adenocarcinoma; PSA and PSAP can help distinguish primary bladder adenocarcinoma from prostate adenocarcinoma.

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“…The 5-year survival rates range from 12 to 75% depending on the clinical stage and morphologic features, with poorer prognosis for pure diffuse tumors and stage IV tumors compared with mixed tumors and stage II tumors, respectively [6]. Of the histopathological cases reported in the literature, tissue sections often revealed urothelial carcinoma with glandular/signet ring cell differentiation or, less often, signet ring variant of primary adenocarcinoma of the urinary bladder arising from either urachal or non-urachal origin [14,15,16,17,18]. …”

Section: Discussionmentioning

confidence: 99%

Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis

Guan¹,

Tatsas²,

Ali³

2012

Acta Cytologica

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Background: Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. Results: There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. Conclusion: Signet ring cell carcinomas are rarely encountered in urinary cytology. The differential diagnosis includes distended histiocytes or degenerated urothelial cells, primary signet ring cell carcinoma, and metastatic adenocarcinoma.

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Cytologic Features of Primary Signet Ring Cell Carcinoma of the Bladder

Cited by 13 publications

References 20 publications

Clinical Characteristics and Outcomes of Patients with Primary Signet-Ring Cell Carcinoma of the Urinary Bladder

Clinical Characteristics and Outcomes of Patients with Primary Signet-Ring Cell Carcinoma of the Urinary Bladder

Urinary Bladder Adenocarcinoma Metastatic to the Abdominal Wall: Report of a Case with Cytohistologic Correlation

Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis

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