Ovarian Serous Cystadenofibroma With Signet Ring-Stromal Cells

Abstract

We report 2 ovarian serous cystadenofibromas with signet ring cells within the stromal component. The signet ring-stromal cells were widespread in 1 case and focal in the other. Immunohistochemically, they were negative with cytokeratin and other epithelial markers and positive with mesenchymal markers. The occurrence of signet ring-stromal cells in ovarian serous cystadenofibromas is an unusual pseudoneoplastic phenomenon, which has not been reported previously, although signet ring cells may occur within a variety of ovarian stromal neoplasms, including fibromas, sclerosing stromal tumors, and signet ring-stromal tumors. In reporting these cases, we review ovarian stromal neoplasms and other lesions with signet ring cells.

Identification of Signet Ring Cell Change in Colonic Subserosa in the Setting ofClostridium difficileColitis

“…However, they may also be identified in reactive processes or in association with epithelial or nonepithelial neoplasms, and mimic signet ring cell carcinoma. Signet ring cell change has been described across several organ systems in nonepithelial and epithelial cells including lymphocytes and smooth muscle cells in transurethral prostate specimens, 2 stromal cells in uterine cervix, 7 histiocytes in sinus cell histiocytosis, 3 stromal cells in the endometrium and ovary, 8 benign colonic epithelial cells in pseudomembranous colitis, 4,[10][11][12]14 tubular adenomas, 5 Peutz-Jeghers polyps, 13 cystic fibrosis and ulcerative colitis, 12,13 benign gastric epithelial cells in acute erosive gastropathy and MALT lymphoma, 6,9 and benign gallbladder epithelial cells in cholelithiasis. 5 In the gastrointestinal tract, signet ring cell change affects mainly the epithelial cells adjacent to areas of ulceration or ischemia and is usually limited to the mucosa.…”

“…Since then, there have been several cases reports of signet ring cell change across other organ systems. [3][4][5][6][7][8] In the gastrointestinal tract, the majority of cases involve benign epithelial cells adjacent to areas of ischemia or injury. [4][5][6][9][10][11][12][13][14] In contrast, signet ring cell change in nonepithelial cells is a very rare finding so far observed in muciphages, 15 Schwannoma cells, 16 and (in a single case report) subserosal adipocytes in the setting of chronic ischemic enteritis.…”

On the Pathogenesis of Sclerosing Stromal Tumor of the Ovary

“…In the latter tumor, the signet-ring cells contain intracytoplasmic mucin as determined by periodic acid Schiff with diastase digestion and can be identified as being composed of epithelial cells by immunohistochemical stains for epithelial membrane antigen. Krukenberg tumor is positive for epithelial membrane antigen and is negative for vimentin, whereas SST and other ovarian stromal tumors are positive for vimentin and negative for epithelial membrane antigen (36). Some ovarian carcinomas occasionally contain signet-ring cells, but the histologic differences otherwise make the distinction from ovarian stromal tumors easy (37).…”

Endometrial Adenocarcinoma With Signet Ring Cells

“…Signet ring cells may also be present in ovarian stromal tumors, such as sclerosing stromal tumor, signet ring-stromal tumor, and occasional fibromas. A recent report has described 2 cases of ovarian serous cystadenofibroma with signet ring cells within the stromal component (11).…”